A Rare Cause of Hemoptysis in West Syndrome—Isolated Aortopulmonary Collaterals in Structurally Normal Heart

Major aortopulmonary collateral arteries (MAPCAs) are abnormal systemic to pulmonary collateral vessels originating from the persistent segmental arteries. The common conditions concomitant with MAPCA are congenital heart diseases with reduced pulmonary blood flow. Isolated MAPCAs represent occurrence of collaterals in the absence of underlying heart disease, which commonly present as heart failure, recurrent respiratory tract infection, and pulmonary artery hypertension. Here, we describe a case of West syndrome presenting with hemoptysis due to isolated MAPCAs and its causal relation and management.

Isolated left subclavian with a compensatory ductus in a child with Tetralogy of Fallot

Tetralogy of Fallot is a cyanotic heart disease wherein aortopulmonary collaterals serve as source of pulmonary blood flow to maintain oxygenation. We report an incidentally detected isolated left subclavian artery supplying a compensatory ductus in a child with Tetralogy of Fallot that effectively contributed as a de novo palliative systemic to pulmonary artery shunt. Clinically, the entity could not be suspected, as the child did not have symptoms suggestive of arterial insufficiency of the left arm or weak pulses or neurological symptoms. The child underwent successful intracardiac repair with a reimplantation of left subclavian artery to left common carotid artery.

Right ventricular outflow tract stenting in the management of tetralogy of Fallot with pulmonary artery hypoplasia and major aortopulmonary collaterals

Fallot’s tetralogy is the most common cyanotic congenital heart lesion. It is a term that encompasses a spectrum of morphologies, all emerging from the fundamental feature of anterior deviation of the outlet septum and associated abnormalities of pulmonary blood flow. This case follows the journey of a patient with severe Fallot’s tetralogy and multifocal pulmonary blood flow from the neonatal period through to his post-operative period. The case explores key points in the assessment of these patients, addressing the medical, interventional, and surgical options for neonatal cyanosis, and then goes on to discuss common issues and pitfalls surrounding peri-operative care.

Unusual Case of Common Arterial Trunk With Atresia of the Right Pulmonary Artery and Aortopulmonary Collaterals

We describe a two-year-old African girl with late diagnosis of unusual case of common arterial trunk with two separate pulmonary artery branch origins from the ascending aorta, hypoplastic right pulmonary artery that becomes atretic and reconstitutes at hilum, and three aortopulmonary collaterals providing right lung blood supply. She underwent single-stage intracardiac repair and unifocalization of collaterals.