Tetralogy of Fallot with Major Aortopulmonary Collateral Arteries

2017 ◽  
pp. 69-80
Author(s):  
Justin Ryan ◽  
Stephen Pophal
Keyword(s):  
Tetralogy Of Fallot ◽  
Major Aortopulmonary Collateral Arteries ◽  
Collateral Arteries ◽  
Aortopulmonary Collateral

scholarly journals Angiographic Anatomy of Major Aortopulmonary Collateral Arteries and Association With Early Surgical Outcomes in Tetralogy of Fallot

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Gregory T. Adamson ◽  
Doff B. McElhinney ◽  
Yulin Zhang ◽  
Jeffrey A. Feinstein ◽  
Lynn F. Peng ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Surgical Outcomes ◽  
Pulmonary Circulation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Major Aortopulmonary Collateral Arteries ◽  
Collateral Arteries ◽  
Total Cross Sectional Area ◽  
Aortopulmonary Collateral

Background Due in part to the heterogeneity of the pulmonary circulation in patients with tetralogy of Fallot and major aortopulmonary collateral arteries (MAPCAs), research on this condition has focused on relatively basic anatomic characteristics. We aimed to detail pulmonary artery (PA) and MAPCA anatomy in a large group of infants, assess relationships between anatomy and early surgical outcomes, and consider systems for classifying MAPCAs. Methods and Results All infants ( <1 year of age) undergoing first cardiac surgery for tetralogy of Fallot/MAPCAs from 2001 to 2019 at Stanford University were identified. Preoperative angiograms delineating supply to all 18 pulmonary segments were reviewed for details of each MAPCA and the arborization and size of central PAs. We studied 276 patients with 1068 MAPCAs and the following PA patterns: 152 (55%) incompletely arborizing PAs, 48 (17%) normally arborizing PAs, 45 (16%) absent PAs, and 31 (11%) unilateral MAPCAs. There was extensive anatomic variability, but no difference in early outcomes according to PA arborization or the predominance of PAs or MAPCAs. Patients with low total MAPCA and/or PA cross‐sectional area were less likely to undergo complete repair. Conclusions MAPCA anatomy is highly variable and essentially unique for each patient. Though each pulmonary segment can be supplied by a MAPCA, central PA, or both, all anatomic combinations are similarly conducive to a good repair. Total cross‐sectional area of central PA and MAPCA material is an important driver of outcome. We elucidate a number of novel associations between anatomic features, but the extreme variability of the pulmonary circulation makes a granular tetralogy of Fallot/MAPCA classification system unrealistic.

Coil embolization of aortopulmonary collateral arteries as an emergency in infants and children

1993 ◽  
Vol 3 (2) ◽  
pp. 141-143 ◽  
Author(s):  
Ugo Vairo ◽  
Luigi Ballerini ◽  
Duccio di Carlo ◽  
Luciano Pasquini ◽  
Roberto Di Donato ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Pulmonary Stenosis ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Transcatheter Embolization ◽  
Ventricular Outflow Tract ◽  
Pulmonary Congestion ◽  
Major Aortopulmonary Collateral Arteries ◽  
Collateral Arteries ◽  
Aortopulmonary Collateral

SummaryEmbolization of major aortopulmonary collateral arteries by coils introduced via catheterization is a well-established procedure for the control of excessively high pulmonary blood flow in patients with tetralogy of Fallot and pulmonary stenosis or atresia. Under special circumstances, this procedure can be life-saving. Between October 1987 and February 1992, four patients with tetralogy of Fallot and pulmonary atresia and one patient with pulmonary stenosis rather than atresia underwent transcatheter embolization of major aortopulmonary collateral arteries as an emergency. Their ages ranged from 41 days to 13 years, with a mean of 45 months. Two patients had recently undergone surgical repair of tetralogy of Fallot while one had been palliated by enlarging the right ventricular outflow tract without closing the ventricular septal defect. All three had been dependent on mechanical ventilation in the postoperative period with signs of pulmonary congestion or intraparenchymal hemorrhage. Eight embolizations were attempted with 0.025 or 0.038 inch coils; seven collateral arteries were completely occluded and one was partially occluded. Thirteen coils were used in total. The systemic saturation rose in one postsurgical patient, with radiological evidence of decreased pulmonary congestion and regression of hemorrhage. In the other cases, the systemic saturation was unchanged. Peak pulmonary arterial pressures dropped in two patients but remained unchanged in three. Our experience suggests that embolization of major aortopulmonary collateral arteries can be beneficial in critical patients, thus avoiding the risks of surgical reexploration.

scholarly journals Tetralogy of Fallot with major aortopulmonary collateral arteries.

Heart ◽  
1985 ◽  
Vol 53 (2) ◽  
pp. 167-172 ◽  
Author(s):  
J M Ramsay ◽  
F J Macartney ◽  
S G Haworth
Keyword(s):  
Tetralogy Of Fallot ◽  
Major Aortopulmonary Collateral Arteries ◽  
Collateral Arteries ◽  
Aortopulmonary Collateral
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