Abstract
Angiography and transcatheter interventions play an integral role in the management of tetralogy of Fallot with pulmonary atresia and major aorto-pulmonary collaterals (TOF/PA/MAPCAs). This role starts with a complete diagnostic investigation that delineates the anatomy of each source of pulmonary blood flow, as well as the vascular health of each segment of lung. Transcatheter interventions are also used to eliminate unnecessary or potentially harmful sources of pulmonary blood flow, to maximize the health of the distal vasculature and to optimize the anatomy after surgical repair has been completed. In addition, the majority of these patients will have a right ventricle-to-pulmonary artery conduit as part of their surgical repair, and this will require transcatheter interventions to treat conduit dysfunction in most patients. In this chapter, we will focus on the role of cardiac catheterization in the diagnostic evaluation of TOF/PA/MAPCAs and the role of transcatheter interventions as part of an integrated strategy to manage this complicated disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bauser-Heaton H, Borquez A, Han B, Ladd M, Asija R, Downey L, et al. Programmatic approach to management of tetralogy of fallot with major aortopulmonary collateral arteries: a 15-year experience with 458 patients. Circ Cardiovasc Interv. 2017;10(4):e004952.
Norgaard MA, Alphonso N, Cochrane AD, Menahem S, Brizard CP, d’Udekem Y. Major aorto-pulmonary collateral arteries of patients with pulmonary atresia and ventricular septal defect are dilated bronchial arteries. Eur J Cardiothorac Surg. 2006;29(5):653–8.
Rabinovitch M, Keane JF, Fellows KE, Castaneda AR, Reid L. Quantitative analysis of the pulmonary wedge angiogram in congenital heart defects. Correlation with hemodynamic data and morphometric findings in lung biopsy tissue. Circulation. 1981;63(1):152–64.
Keane JF, McFaul R, Fellows K, Lock J. Balloon occlusion angiography in infancy: methods, uses and limitations. Am J Cardiol. 1985;56(7):495–7.
Lim JS, Desai T, Stumper O. Dual-catheter balloon occlusion aortography in pulmonary atresia with ventricular septal defect and major aorto-pulmonary collaterals. Pediatr Cardiol. 2004;25(5):500–2.
Singh SP, Rigby ML, Astley R. Demonstration of pulmonary arteries by contrast injection into pulmonary vein. Br Heart J. 1978;40(1):55–7.
Meng CC, Eckner FA, Lev M. Coronary artery distribution in Tetralogy of Fallot. Arch Surg. 1965;90:363–6.
Kapur S, Aeron G, Vojta CN. Pictorial review of coronary anomalies in Tetralogy of Fallot. J Cardiovasc Comput Tomogr. 2015;9(6):593–6.
Bergersen LJ, Perry SB, Lock JE. Effect of cutting balloon angioplasty on resistant pulmonary artery stenosis. Am J Cardiol. 2003;91(2):185–9.
Mainwaring RD, Patrick WL, Carrillo SA, Ibrahimye AN, Muralidaran A, Hanley FL. Prevalence and anatomy of retroesophageal major aortopulmonary collateral arteries. Ann Thorac Surg. 2016;102(3):877–82.
Butera G, Abella R, Carminati M, Frigiola A. Perventricular implantation of a right ventricular-to-pulmonary artery ‘conduit’. Eur Heart J. 2009;30(17):2078.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Porras, D. (2021). Transcatheter Treatments in PA-VSD-MAPCAs. In: Butera, G., Chessa, M., Eicken, A., Thomson, J. (eds) Cardiac Catheterization for Congenital Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-69856-0_56
Download citation
DOI: https://doi.org/10.1007/978-3-030-69856-0_56
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-69855-3
Online ISBN: 978-3-030-69856-0
eBook Packages: MedicineMedicine (R0)