Development of systemic to pulmonary collateral arteries in premature infants

Pediatric Pulmonology Year in Review 2018: Rare lung disease, neuromuscular disease, and diagnostic testing

“…Older studies have documented their asymptomatic occurrence and spontaneous resolution in preterm infants. [26][27][28] It is notable, however, that before catheterization, evidence of bleeding was visualized by bronchoscopy on the same lung as the APCs in four of the six cases. The role for cardiac catheterization in diagnosing and treating APCs is unclear in patients with pulmonary hemorrhage and no other identifiable cause.…”

A literature review of systemic to pulmonary collaterals in preterm infants to emphasise their existence and clinical importance

“…Early literature on this topic consists mostly of case reports of significant systemic to pulmonary collaterals (SPCs) requiring surgical intervention, the earliest being in the 1980s . Using colour Doppler on ultrasound echocardiography, Shaughessy et al reported the incidence of detectable SPC in the preterm population to be 4%. This group identified 20 infants with SPC of a total of 500 echocardiography scans.…”

“…SPC does occur in newborns with no CHD, whether term or preterm . SPCs had been thought to be of no clinical significance; however, where they occur in infants with chronic lung disease (CLD), physiologically they may affect the respiratory mechanism in a similar way as a PDA and can mimic symptomatic ductal shunting . In this article, we wish to emphasise the presence and the possible significance of SPC in infants with no CHD and provide a guide for the identification of SPC for the increasing number of neonatologists performing cardiac ultrasound in newborn infants, especially in the preterm population.…”

Expedited Oxygen Wean After Coil Embolization of Systemic-to-Pulmonary Collaterals in a Premature Infant With Bronchopulmonary Dysplasia

“…Thus, this case, along with the previous reports, shows the value of careful echocardiographic evaluation for SPCs in premature infants with prolonged supplemental oxygen requirements. 2,3 Despite the lack of echocardiographic evidence for volume overload, SPCs may be clinically important in premature infants with chronic lung disease and leaky capillaries, warranting the consideration of therapeutic coil embolization.…”

“…1,2 Systemic-to-pulmonary collaterals can also occur in premature infants without cardiac or lung disease; such collateral vessels appear to be transient. 3 Occasionally, SPCs result in left-to-right shunts that warrant intervention. 2,4,5 We describe the case of a preterm infant whom we weaned from chronic supplemental oxygen after coil embolization of 2 persistent SPCs.…”