Patton D J, Fouron J C
Department of Pediatric Cardiology, Izaak Walton Killam Children's Hospital, Halifax, Nova Scotia, Canada.
Pediatr Cardiol. 1995 May-Jun;16(3):141-4. doi: 10.1007/BF00801914.
Using the Doppler technique, this study compared the prenatal and postnatal flow patterns of an infant with cerebral arteriovenous (AV) malformation. Fetal right ventricular end-diastolic dimension was 1.7 cm with right ventricular ejection equaling 66% of the combined cardiac output. Diastolic flow was reversed in the fetal aortic isthmus but forward-moving in the descending aorta, resulting in a watershed phenomenon. In the carotid arteries an increased forward diastolic flow was noted while the internal jugular vein exhibited a pulsatile arterial type of flow. The pulsatility index of the umbilical artery was normal. After birth and closure of the ductus arteriosus, the output from both ventricles was equally increased, and retrograde diastolic flow was then observed in the descending aorta. In conclusion, specific fetal features of cerebral AV malformation are increased right ventricular output probably related to the increased superior vena cava return, watershed phenomenon in the descending aorta causing the right ventricle to perfuse both the lower and upper body, and preserved umbilical circulation.
本研究采用多普勒技术，比较了一名患有脑动静脉畸形婴儿的产前和产后血流模式。胎儿右心室舒张末期内径为1.7厘米，右心室射血占心输出量总和的66%。胎儿主动脉峡部舒张期血流逆向，但降主动脉中血流向前，导致分水岭现象。颈动脉舒张期向前血流增加，而颈内静脉呈现搏动性动脉血流类型。脐动脉搏动指数正常。出生后动脉导管关闭，两个心室的输出均同等增加，随后在降主动脉中观察到舒张期逆向血流。总之，脑动静脉畸形的特定胎儿特征为右心室输出增加，可能与上腔静脉回流增加有关；降主动脉出现分水岭现象，导致右心室为下半身和上半身供血；脐循环得以保留。
