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

Abstract

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.

Large isolated major aortopulmonary collateral artery causing dilated left ventricle

“…In rare cases, MAPCAs may present with no evidence of congenital heart disease, especially in preterm neonates; they are usually small and rarely symptomatic and often regress on their own [2] . Symptomatic isolated MAPCAs have been described as having features of left-to-right shunt and present as recurrent respiratory tract infections, pulmonary hypertension, congestive cardiac failure, bronchopulmonary dysplasia, or hemoptysis [3] , [4] , [5] , [6] , [7] . Very few isolated MAPCAs have been recorded in full-term babies, and even fewer have been reported to need intervention [8] .…”