Abstract:
Pulmonary arteriovenous malformations (AVMs) are abnormal connections between the pulmonary arteries and veins that can result in rapid-onset heart failure. We present a case of a fetus with pulmonary AVMs diagnosed at 22 weeks gestation. Fetal echocardiography showed cardiomegaly and dilated pulmonary arteries and veins reflecting the hemodynamic significance of the shunt. Inverted flow through the ductus arteriosus was also present. Fetal autopsy following medical termination of the pregnancy confirmed the morphological findings, including displacement of arteries and veins in proximity to the pleural surface. The genetic study was negative. This report highlights the cardiovascular impact of a rare disorder. Inverted flow through the ductus arteriosus may be another poor prognostic indicator, useful in parental counseling.
摘要:
肺动静脉畸形(AVM)是肺动脉和静脉之间的异常连接,可导致快速发作的心力衰竭。我们介绍了一例在妊娠22周时诊断为肺AVM的胎儿。胎儿超声心动图显示心脏增大和肺动脉和静脉扩张,反映了分流术的血流动力学意义。还存在通过动脉导管的倒流。医学终止妊娠后的胎儿尸检证实了形态学发现,包括靠近胸膜表面的动脉和静脉移位。基因研究结果为阴性。本报告强调了一种罕见疾病对心血管的影响。通过动脉导管的倒流可能是另一个不良预后指标,在家长咨询中有用。