Pulmonary Atresia With Ventricular Septal Defects and Major Aortopulmonary Collateral Arteries  18-Year Clinical Experience and Angiographic Follow-up of Major Aortopulmonary Collateral Arteries

Song, Suk-Won; Park, Han Ki; Park, Young-Hwan; Cho, Bum Koo

doi:10.1253/circj.cj-08-0324

Cited by 31 publications

(11 citation statements)

References 19 publications

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“…Clinical manifestations in these children can vary widely depending on the presence of a patent DA and/or native pulmonary arteries as well as on the distribution of the pulmonary arteries and the MAPCAs to the pulmonary segments. Recent advances in the fields of interventional cardiology and cardiovascular surgery have increasingly allowed more patients to achieve a biventricular circulation [22], by different approaches [23,24,25] that are basically intended to complete the unifocalization of the supplying MAPCAs, with or without incorporation of the central pulmonary arteries, if present, and concomitant or delayed closure of the VSD. On the other hand, previous studies [2,26,27] have demonstrated that fetuses with a 22q11.2 microdeletion have more severely hypoplastic central pulmonary arteries and more branching anomalies, which determines a poorer postnatal outcome.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

et al. 2015

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Objectives: To report on the accuracy of fetal echocardiography in the distinction between truncus arteriosus communis (CAT) and pulmonary atresia with ventricular septal defect (PA-VSD) and to describe the association with extracardiac and chromosomal anomalies. Methods: This was a retrospective study on 31 fetuses with a single arterial trunk overriding a VSD with a nonidentifiable right ventricle outflow tract with anterograde flow. Data on the type of cardiac defect, gestational age, characteristics of the arterial trunk valve, presence of additional vascular, chromosomal and extracardiac abnormalities and postnatal outcome were obtained. Misdiagnosed cases were reevaluated by four-dimensional spatiotemporal image correlation (4D-STIC) echocardiography. Results: The overall diagnostic accuracy was 81% and increased to 93.5% with 4D-STIC. Chromosomal and extracardiac anomalies were detected in 40 and 27%, respectively. In the PA-VSD group, patent ductus arteriosus and major aortopulmonary collateral arteries (MAPCAs) were present in 70 and 50% of the cases, respectively, coexisting in 1 of 5 cases. MAPCAs were significantly associated with a right aortic arch and with a 22q11 microdeletion in 50% of cases. Conclusions: A prenatal distinction between CAT and PA-VSD can currently be achieved in most cases. MAPCAs should be actively searched for when PA-VSD is suspected, as they are associated with a higher risk of 22q11 microdeletion and potentially complicate postnatal treatment.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

et al. 2015

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“…Studies with extensive follow-up demonstrating improved survival and increased rates of surgical repair, however, are scarce [7,9]. Further, most studies concerning survival into adulthood have concentrated on only PA + VSD patients with MAPCAs [4,10], and the data on the MAPCAs' effects on the survival of PA + VSD are controversial [9,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome after treatment of pulmonary atresia with ventricular septal defect: nationwide study of 109 patients born in 1970–2007

Kaskinen

Happonen

Mattila

et al. 2015

Eur J Cardiothorac Surg

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These findings show that achievement of repair and initial size of true central pulmonary arteries affect survival of patients with PA + VSD. Although the overall survival of patients with MAPCAs showed no difference compared with simple PA + VSD patients, they had a higher risk of remaining palliated. However, palliative surgery may have a role in treatment of PA + VSD because the size of pulmonary arteries increased after placement of systemic-pulmonary artery shunt. In addition, subtotal repair by a RV-pulmonary artery connection and septal fenestration improved survival over extracardiac palliation.

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“…Several groups continue to advocate the use of either a central shunt or right ventricle to pulmonary artery conduit as the principal method to achieve "pulmonary artery rehabilitation" [12][13][14][15][16]. The central pulmonary arteries can also be utilized in conjunction with unifocalization of MAPCAs for repair of PA/VSD/MAPCAs [6][7][8][9][10][11][17][18][19]. This strategy provides a versatile approach to the management of PA/VSD/MAPCAs and has yielded excellent hemodynamic results [20].…”

mentioning

confidence: 99%

Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries

Carrillo

Mainwaring

Patrick

et al. 2015

The Annals of Thoracic Surgery

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Pulmonary Atresia With Ventricular Septal Defects and Major Aortopulmonary Collateral Arteries 18-Year Clinical Experience and Angiographic Follow-up of Major Aortopulmonary Collateral Arteries

Cited by 31 publications

References 19 publications

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

Long-term outcome after treatment of pulmonary atresia with ventricular septal defect: nationwide study of 109 patients born in 1970–2007

Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries

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