Unrepaired Tetralogy of Fallot with Major Aortopulmonary Collateral Arteries in an Adult Patient

Antonetti, Illena; Lorch, Daniel; Coe, Brian; Maxey, Thomas S.; Nallamshetty, Leelakrishna; Dadlani, Gul H.; Berlowitz, Michael; Cohen, Adam J.; Guglin, Maya

doi:10.1111/j.1747-0803.2011.00598.x

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…21 Tetralogy of Fallot with MAPCA is a complex form of cyanotic congenital heart disease that requires a comprehensive team-based assessment prior to surgical intervention. 22 Cardiac catheterization is usually essential to obtain all the necessary information. 19 Patients may occasionally present with multiple, large, unobstructed aortopulmonary collateral arteries producing excessive flow of blood to the lungs, and necessitating intervention.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting perioperative mortality in tetralogy of Fallot

Saygı

Ergül

Tola

et al. 2015

Pediatrics International

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Poor preoperative oxygenation, presence of coronary anomaly, complete AV block in the early postoperative period, high RV pressure and requirement of ECMO appear to be the most significant factors that affect early mortality in the surgical treatment of TOF. Appropriate preoperative assessment, correct surgical strategies and attentive intensive care monitoring are required in order to reduce mortality.

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Section: Discussionmentioning

confidence: 99%

Factors affecting perioperative mortality in tetralogy of Fallot

Saygı

Ergül

Tola

et al. 2015

Pediatrics International

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“…MAPCAs can develop in other conditions like TOF with pulmonary atresia and in this condition pulmonary circulation is dependent on these collateral [12]. MAPCAs can be an additional source of blood flow to lungs along with native pulmonary arteries like TOF with pulmonary stenosis [13,14].…”

Section: Discussionmentioning

confidence: 99%

Perioperative Major Aortopulmonary Collateral Arteries (MAPCAs) Coiling in Tetralogy of Fallot Patients Undergoing for Total Correction

2015

JCCR

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Background: Tetralogy of Fallot (TOF) is characterized by ventricular septal defect, an overriding aorta, varying degrees of pulmonic stenosis, and right ventricular hypertrophy. It may be associated with a number of lesions including development of major aortopulmonary collateral arteries (MAPCAs) in less than 5% of cases. In this study we just focused on the management of MAPCAs.Methodology: TOF patients with significant MAPCAs were selected after cardiac catheterization and planned for transcatheter embolization just before surgery.Results: A total of 45 patients underwent transcatheter closure of MAPCAs just before surgical correction with 100% success rate. The age varied from 3-30 years and 55% (n=25) were female. In majority 60% (n=27) the procedure was carried out under deep sedation with local anaesthesia while 18 (40%) patients had general anaesthesia. There was insignificant residual leak in 2 (4%) patients, transient bradycardia (n=1) and hypercyanotic spell in 4% (n=2). No serious complications or death occurred during this study period. Conclusion:Transcatheter coiling of MAPCAs is safe, easy, and effective procedure and protects the patient from its long term devastating complications.

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“…Such repairs involve the closure of ventricular septal defect, relief of right ventricular outflow tract obstruction, maintenance of pulmonary valve competency when possible, and establishment of laminar pulmonary blood flow to all segments of the pulmonary bed. 10 In addition, it has been reported that the presence of foetal major aortopulmonary collateral arteries is associated with adverse outcome, therefore early diagnosis is essential. 11 In patients with pulmonary atresia and major aortopulmonary collateral arteries such as one reported in the present case, different surgical procedures are used as treatment.…”

Section: Discussionmentioning

confidence: 99%

A case of single ventricular heart, pulmonary atresia, patent ductus arteriosus, major aortopulmonary collateral arteries

Nair

Mookambika

et al. 2015

Asian J Med Sci

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We report a case of multiple congenital anomalies in a female newborn infant, born to the mother from a hill tribe. The Doppler echocardiography of the baby showed large atrial septal defect amounting to single atrium, atretic left atrioventricular valve, large single right sided ventricle, aorta shifted to the left arising from single ventricle and diminutive hypoplastic left ventricle. Right atrioventricular valve was normal forming single inlet into the ventricle. Pulmonary artery was small and hypoplastic and no antegrade flow was observed in it. The patient was diagnosed as having single ventricle, pulmonary atresia, patent ductus arteriosus (PDA) and major aortopulmonary collateral artery (MAPCA). compared to an earlier report from South India (25.6 per 1000 live births). 1,5 Ventricular septal defects are found to be the most prevalent type of defects in most of the studies on Indian population. 1 The frequency of other rare types of CHDs namely atrioventricular septal defects, pulmonary stenosis, single ventricle, hypoplastc left heart syndrome has been reported to be less in India when compared to the data from western population.1 It can be noted here that most of the congenital heart defects which are considered to be less frequent among Indian population, like single ventricle, pulmonary atresia, atrial septal defect, hypoplastic left ventricle have been observed in the present case along with exomphalos.It has been reported that the most commonly observed CHDs are ventricular septal defects with pulmonary atresia.6 Ugurlucan et al. have reported a case of ventricular septal defect, pulmonary atresia, non-confluent cardiac anomalies, pulmonary arteries and bilateral patent ductus arteriosi.7 Similar case of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries has been reported in a 10 month old Thai baby. 8 In the present case, though the patient showed other associated cardiac anomalies, pulmonary atresia, patent ductus arteriosus and major aortopulmonary collateral arteries are considered as functionally significant. When there is such multiple congenital cardiac anomalies, aortic arch anomalies like patency of ductus arteriosus and major aortopulmonary collateral arteries are common and vital, otherwise death is inevitable.7 Pulmonary atresia with intact ventricular septum causing sudden death due to myocardial ischaemia is well-established. 9 However, in the present case, though there was no ventricular septal defect, the patient survived, may be due the origin of aorta from the single right ventricle and major aortopulmonary collateral arteries.Though the formation of major aortopulmonary collateral vessels is essential for the survival of patients with pulmonary atresia and ventricular septal defects, they pose a unique and challenging problem at the time of surgical repair. Such repairs involve the closure of ventricular septal defect, relief of right ventricular outflow tract obstruction, maintenance of pulmonary valve competency when possible, and establ...

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Unrepaired Tetralogy of Fallot with Major Aortopulmonary Collateral Arteries in an Adult Patient

Cited by 7 publications

References 10 publications

Factors affecting perioperative mortality in tetralogy of Fallot

Factors affecting perioperative mortality in tetralogy of Fallot

Perioperative Major Aortopulmonary Collateral Arteries (MAPCAs) Coiling in Tetralogy of Fallot Patients Undergoing for Total Correction

A case of single ventricular heart, pulmonary atresia, patent ductus arteriosus, major aortopulmonary collateral arteries

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