scholarly journals Case Report: A forty year-survivor of Tetralogy of Fallot with pulmonary atresia and chronic pediatric shunt thrombosis; findings from cardiac CT scan

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 647
Author(s):  
Asma Achour ◽  
Walid Mnari ◽  
Mabrouk Abdelali ◽  
Ahmed Zrig ◽  
Ahmed Miladi ◽  
...  
Keyword(s):  
Ct Scan ◽  
Tetralogy Of Fallot ◽  
Cardiac Ct ◽  
Sinus Tachycardia ◽  
Pulmonary Atresia ◽  
Clinical Findings ◽  
Late Outcome ◽  
Shunt Thrombosis ◽  
Collateral Arteries ◽  
Progressive Dyspnea

Here we illustrate a rare case of Tetralogy of Fallot (TOF) with pulmonary atresia in a 40-year-old survivor patient, despite a chronic pediatric shunt thrombosis. The patient became symptomatic at 38-years-old with progressive dyspnea on exertion and short cyanosis spells. The clinical findings were unspecific except for sinus tachycardia. To reassess cardiac abnormalities and associated intrathoracic malformations, a cardiac CT-scan was performed. Here we explain the mechanism for prolonged survival as an expansion of several and huge major aortopulmonary collateral arteries. This case predicts an exceptional late outcome of untreated TOF.

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.

Arterial supply to the lungs in tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis

1992 ◽  
Vol 2 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Siew Yen Ho ◽  
Gualtiero Catani ◽  
Jeong-Wook Seo
Keyword(s):  
Tetralogy Of Fallot ◽  
Pulmonary Stenosis ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Arterial Supply ◽  
Collateral Arteries ◽  
Pulmonary Parenchyma ◽  
Different Origins ◽  
Different Sources ◽  
Critical Pulmonary Stenosis

SummaryThe arterial supply to the lungs in cases with tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis is mostly via the arterial duct or else by collateral arteries arising directly or indirectly from the aorta. Nine anatomical specimens with collateral arteries were studied by blunt dissection to determine the arterial supply to each pulmonary segment. The precise supply varied from case to case but, overall, nearly two-thirds of the pulmonary segments were connected to the central pulmonary arteries. A quarter were supplied exclusively by systemic-to-pulmonary collateral arteries, with the remainder having a dual supply. Coexistence of ductal connections and systemic-to-pulmonary collateral arteries was seen in one case. Anastomoses between vessels of different origins were observed up to the segmental level in eight of the nine cases. In four cases, the anastomoses formed arterial rings. The extent of pulmonary parenchyma supplied by arteries from different sources and the presence of arterial anastomoses in these malformations have implications on the planning of surgical repair.

Use of pre-intervention imaging with a novel image fusion software for guidance of cardiac catheterisation in a patient with pulmonary atresia and major aortopulmonary collaterals

2016 ◽  
Vol 26 (7) ◽  
pp. 1438-1440 ◽  
Author(s):  
Sebastian Goreczny ◽  
Pawel Dryzek ◽  
Tomasz Moszura
Keyword(s):  
Image Fusion ◽  
Ct Scan ◽  
Tetralogy Of Fallot ◽  
Pulmonary Atresia ◽  
Cardiac Catheterisation ◽  
Two Dimensional ◽  
Heart Catheterisation ◽  
Aortopulmonary Collaterals ◽  
Selective Cannulation ◽  
Major Aortopulmonary Collaterals

AbstractWe present a 3.5-year-old patient with tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collaterals, after repeat implantation of a central shunt, in whom we successfully re-purposed previous imaging scans with a novel image fusion software to guide diagnostic heart catheterisation. The pre-registered CT scan was segmented before the procedure and subsequently manually fused with two-dimensional fluoroscopy images. The overlaid roadmap enhanced selective cannulation of all major vessels originating from the aorta, making aortography unnecessary.

Systemic-to-pulmonary blood supply in tetralogy of Fallot with pulmonary atresia

2002 ◽  
Vol 12 (4) ◽  
pp. 373-388 ◽  
Author(s):  
Renata N. Rossi ◽  
Alison Hislop ◽  
Robert H. Anderson ◽  
F. Maymone Martins ◽  
Andrew C. Cook
Keyword(s):  
Tetralogy Of Fallot ◽  
Blood Supply ◽  
Pulmonary Atresia ◽  
Arterial Supply ◽  
Pulmonary Vasculature ◽  
Cardiac Malformations ◽  
Collateral Arteries ◽  
Pulmonary Arterial ◽  
Clinical Correlations ◽  
Arterial Anatomy

AbstractTetralogy of Fallot with pulmonary atresia is one of the most challenging congenital cardiac malformations, for the morphologist, cardiologist and surgeon alike. Much of the difficulty in this lesion concerns the nature and development of pulmonary arterial supply, and the manner in which complete segmental supply to the lungs can be successfully restored or maintained. In this review, we discuss the anatomy and nomenclature of the lesion, emphasising the variability that can occur in pulmonary arterial anatomy, particularly in the presence of systemic-to-pulmonary collateral arteries. We speculate on the likely embryologic origins of these connections. Then by means of anatomic-clinical correlations, we emphasise the diagnostic approach to delineating the origin and extent of the pulmonary vasculature.

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