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. Author manuscript; available in PMC: 2016 Jun 1.
Published in final edited form as: Trends Neurosci. 2015 May 1;38(6):353–363. doi: 10.1016/j.tins.2015.04.001

Figure 1.

Figure 1

Fetal cerebral circulation, white matter (WM) damage, and risk factors associated with neurological outcomes in congenital heart disease (CHD). (A,B) Cartoon illustrating fetal cerebral blood flow. In normal fetuses (A), oxygenated blood (red arrows) from the placenta is preferentially pumped to the left heart, exits through the carotid arteries, and flows to the brain. In fetuses with hyoplastic left heart syndrome (HLHS) (B), oxygenated and deoxygenated (blue arrows) blood mix (purple arrows) and is misdirected to the aorta, bypassing the carotid arteries. Retrograde flow of mixed blood exits through the carotid arteries at a low flow rate to the brain. In HLHS, developing fetal brains receive less and hypoxic blood, resulting in delayed WM maturation. (C,D) Risk factors associated with neurological deficits in CHD patients throughout life.