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Early echocardiographic predictor of heart failure in cerebral arteriovenous malformations

Published online by Cambridge University Press:  08 April 2016

Poonam P. Thankavel*
Affiliation:
Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center at Dallas and Children’s Medical Center of Dallas, Dallas, Texas, United States of America
Claudio Ramaciotti
Affiliation:
Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center at Dallas and Children’s Medical Center of Dallas, Dallas, Texas, United States of America
*
Correspondence to: P. P. Thankavel, MD, Department of Pediatrics, Division of Pediatric Cardiology, UT Southwestern Medical Center, Children’s Medical Center of Dallas, 1935 Medical District Drive Dallas, TX 75235, United States of America. Tel: 214 456 2327; Fax: 214 456 8066; E-mail: poonam.punjwani@childrens.com

Abstract

Neonatal congestive heart failure in cerebral arteriovenous malformations carries a high risk of mortality. Severe heart failure leading to end-organ dysfunction may be a contraindication to early intervention. Although echocardiographic markers of haemodynamic instability exist, an objective echocardiographic predictor of severe heart failure is not available. We present a ratio of antegrade to retrograde flow in the aortic arch that objectively identifies those at the highest risk of mortality. This measurement can be easily obtained and has prognostic value at presentation, before clinical deterioration. Outcomes remain poor even when early intervention is offered, which may reflect irreversible neurological abnormalities.

Type
Brief Reports
Copyright
© Cambridge University Press 2016 

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References

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