Major aortopulmonary collateral arteries (MAPCAs) are congenital vessels that arise from the aorta or its first-order branches and are distally connected to the pulmonary arterial vasculature, thereby providing pulmon...Major aortopulmonary collateral arteries (MAPCAs) are congenital vessels that arise from the aorta or its first-order branches and are distally connected to the pulmonary arterial vasculature, thereby providing pulmonary blood flow. MAPCAs are often associated with cyanotic congenital heart disease with decreased pulmonary blood flow. Isolated MAPCAs are rare in patients without congenital heart disease with structurally normal hearts. Sometimes, isolated congenital MAPCAs can occur without any lung disease. Isolated MAPCAs represent the occurrence of collaterals in the absence of underlying heart disease, which commonly presents as heart failure, recurrent respiratory tract infection, and pulmonary artery hypertension. We report a rare case of congestive heart failure in a 6-year-old patient with dual arterial supply to an otherwise normal right lung, with a normal bronchial tree, and a structurally normal heart. The patient was successfully managed by the closure of collaterals by Amplatzer vascular plugs II (AVPII) and Amplatzer Piccolo Occluders.展开更多
A 17-month-old infant with multiple aorto-pulmonary collateral arteries (MAPCAs) and pulmonary hypertension presented for diagnostic catheterization. On the day of the procedure, the infant was asymptomatic with oxyge...A 17-month-old infant with multiple aorto-pulmonary collateral arteries (MAPCAs) and pulmonary hypertension presented for diagnostic catheterization. On the day of the procedure, the infant was asymptomatic with oxygen saturation in the 90’s on 1.0 L/min O2 nasal cannula. His parents denied any recent illness. During the procedure, one coil was inadvertently embolized into the right lung resulting in markedly increased pulmonary artery pressures. The Pa-etCO2 gradient increased to 25 mmHg from a baseline of 2 mmHg. Therapy was initiated to reduce the PaCO2. The patient could not be weaned from mechanical ventilation due to elevated PA pressures.展开更多
文摘Major aortopulmonary collateral arteries (MAPCAs) are congenital vessels that arise from the aorta or its first-order branches and are distally connected to the pulmonary arterial vasculature, thereby providing pulmonary blood flow. MAPCAs are often associated with cyanotic congenital heart disease with decreased pulmonary blood flow. Isolated MAPCAs are rare in patients without congenital heart disease with structurally normal hearts. Sometimes, isolated congenital MAPCAs can occur without any lung disease. Isolated MAPCAs represent the occurrence of collaterals in the absence of underlying heart disease, which commonly presents as heart failure, recurrent respiratory tract infection, and pulmonary artery hypertension. We report a rare case of congestive heart failure in a 6-year-old patient with dual arterial supply to an otherwise normal right lung, with a normal bronchial tree, and a structurally normal heart. The patient was successfully managed by the closure of collaterals by Amplatzer vascular plugs II (AVPII) and Amplatzer Piccolo Occluders.
文摘A 17-month-old infant with multiple aorto-pulmonary collateral arteries (MAPCAs) and pulmonary hypertension presented for diagnostic catheterization. On the day of the procedure, the infant was asymptomatic with oxygen saturation in the 90’s on 1.0 L/min O2 nasal cannula. His parents denied any recent illness. During the procedure, one coil was inadvertently embolized into the right lung resulting in markedly increased pulmonary artery pressures. The Pa-etCO2 gradient increased to 25 mmHg from a baseline of 2 mmHg. Therapy was initiated to reduce the PaCO2. The patient could not be weaned from mechanical ventilation due to elevated PA pressures.
