Doppler echocardiographic and flow-mapping studies in the human fetus

David Sahn

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

In its early application to fetal shunts, several utilities of flow mapping have been defined. Because of ultrasound experience with obstructed foramen ovale in utero and hypotheses about the existence and implications of premature ductal constriction in utero, we recently have completed a study of the flow diameters and velocity characteristics of the foramen ovale and ductus arteriosus. Flow dimensions were expressed as a percent of the diameter of the aortic root measured in short axis. The foramen ovale showed a flow diameter of 74% of the diameter of the aortic root with a mean A-wave dominant diastolic velocity of 42 cm/sec. The ductus, at its insertion into the descending aorta, had a diameter of 85% of the aortic root and a mean velocity of 86 cm/sec. The ductus has the highest systolic velocities in the fetus, which appears to represent a physiological constriction at its insertion. In contrast, a fetus with hydrops and a constricted foramen ovale, recently studied in our laboratory, had a foramenal diameter of 19% and a turbulent A-wave dominant foramenal velocity of 120 cm/sec, suggesting almost a 5 or 6 mmHg transatrial gradient. At autopsy, after intrauterine fetal demise, the foramen was 1.5 x 1.5 mm in size. We have also shown that imaging of the turbulent flows allows characterization of atrioventricular valve regurgitation in atrioventricular septal defects, as well as transventricular flows and left ventricular to right atrial shunts in that disease, and a qualitative relationship between the degree of flow-mapped turbulent regurgitant and the severity of valve insufficiency as indicated by reverse inferior caval and umbilical vein flows on waveform Doppler.

Original languageEnglish (US)
Pages (from-to)119-123
Number of pages5
JournalEchocardiography
Volume6
Issue number2
StatePublished - 1989
Externally publishedYes

Fingerprint

Foramen Ovale
Fetus
Constriction
Ductus Arteriosus
Venae Cavae
Umbilical Veins
Fetal Death
Thoracic Aorta
Autopsy
Edema

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Doppler echocardiographic and flow-mapping studies in the human fetus. / Sahn, David.

In: Echocardiography, Vol. 6, No. 2, 1989, p. 119-123.

Research output: Contribution to journalArticle

Sahn, David. / Doppler echocardiographic and flow-mapping studies in the human fetus. In: Echocardiography. 1989 ; Vol. 6, No. 2. pp. 119-123.
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