Cumming G R
Am J Cardiol. 1980 May;45(5):1019-24. doi: 10.1016/0002-9149(80)90171-x.
Two newborn infants with severe cardiac failure caused by a large cerebral arteriovenous communication were studied with complete cardiac catheterization, indicator-dilution curves and angiography. In one infant, studied at age 10 hours, a large right to left shunt through the patent ductus was seen with retrograde aortic flow into the left carotid artery. The entire flow in the descending aorta was supplied from the ductus. The second infant, studied at age 5 days, had a 20 percent right to left shunt through the foramen ovale and the ductus was closed. Hypoxia was caused by inadequate oxygenation of pulmonary venous blood, atrial right to left shunting and possibly ductal right to left shunting. The hemodynamic findings in cases of cerebral arteriovenous fistula would seem to depend on the patient's age at the time the studies are carried out and the severity of the lesion. Cardiac output was more than twice the normal value and blood flow through the arteriovenous fistula was probably greater than 4 liters/min per m2.
对两名因大脑动静脉交通导致严重心力衰竭的新生儿进行了全面的心导管检查、指示剂稀释曲线测定和血管造影。其中一名婴儿在出生10小时时接受检查，可见通过动脉导管有大量右向左分流，主动脉血流逆行进入左颈动脉。降主动脉的全部血流均由动脉导管供应。第二名婴儿在出生5天时接受检查，通过卵圆孔有20%的右向左分流，且动脉导管已闭合。低氧血症是由于肺静脉血氧合不足、心房右向左分流以及可能存在的动脉导管右向左分流所致。大脑动静脉瘘病例的血流动力学表现似乎取决于进行检查时患者的年龄以及病变的严重程度。心输出量超过正常值两倍以上，通过动静脉瘘的血流量可能大于每平方米4升/分钟。
