Systemic arterial supply to the lungs in pulmonary atresia and its relation to pulmonary artery development.

Jefferson, K; Rees, Simon; Somerville, Jane

doi:10.1136/hrt.34.4.418

Cited by 133 publications

(54 citation statements)

References 7 publications

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“…The right bronchial artery in its course through the mediastinum may form a fine plexus of ves sels in the region of the posterior surface of the heart. The dilatation of such anastomotic channels has been reported in congenital heart anomalies [4,6,7], and in the presence of chronic pulmonary disease [8][9][10][11][12][13][14][15][16][17][18][19] and coronary artery disease [11]. To our knowl edge there are no previous reports of this finding in Takayasu's arteritis.…”

Section: Discussioncontrasting

confidence: 38%

Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

Halon

Turgeman²,

Merdler³

et al. 1987

Cardiology

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A 27-year-old woman presented with ischemia of the left arm and dizziness together with acute lateral wall myocardial ischemia. Physical examination showed narrowing of the arteries to the head and neck and upper limbs suggesting Takayasu’s arteritis. Angiography demonstrated pulmonary and systemic involvement. There was complete occlusion of the right upper lobe pulmonary artery and a large collateral artery from the circumflex coronary artery which anastomosed with the right bronchial artery. This anastomotic channel has not to our knowledge been described in Takayasu’s arteritis.

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Section: Discussioncontrasting

confidence: 38%

Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

Halon

Turgeman²,

Merdler³

et al. 1987

Cardiology

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“…Usually , the MAPCA conn ects with a segmental pulmonary artery at the hilum , which is the only source of blood supply to the segment (1) The MAPCAs have the high incidence of stenosis in their course (1)(2)(3)(4)(5)(6). The sites of stenosis are usuall y at the MAPCA-pulmonary artery connection and at the origin of MAPCA form the aorta (1)(2)(3)(4).…”

Section: Discussionmentioning

confidence: 99%

“…The sites of stenosis are usuall y at the MAPCA-pulmonary artery connection and at the origin of MAPCA form the aorta (1)(2)(3)(4). The stenosis prevents full transmis sion of f10w a nd pressure from the system ic to the pulmonary side and protects the distal pulmonary vascular b ed (3 ,5).…”

Section: Discussionmentioning

confidence: 99%

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The major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect: chest radiologic findings

Kim¹,

Choe²,

Kim³

et al. 1992

J Korean Radiol Soc

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The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) a nd ventricular septal defect (VSD) to determine the characteristic findings of m 에 or aortopulmonary coll a teral arteries (MAPCAs) on the ches t radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common findin g ofMAPCAs was inappropriately large peripheral pulmonary vascula ture (n = 16, 69.6 % ). The other findin gs were tortuosity of pulmonary vasculature (n = 12 , 52.2 %), focal unevendi stribution of pulmonary vasculature (n = 12 , 52 .2 %), and two descending pulmonary arteries (n = 4, 17.4 % ). When chest radiogra ph s showed two or more findin gs of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echocardiography suggests PA with VSD Index Words: Pulmonary atresia , 564 .1 555 Pulmonary artery , coll aterals, 564. 91 Aorta , angiography, 563. 12 4 Lung, radiograph y, 60. 11 1n th e cases of pulmona r y a tresia (PA) with ventricular septal d efect (VSD) , the lungs are usually supplied by patent du ctu s arteriosus (PDA) , m ajor aortopulmonary collateral arteries (MAPCAs) , and acquired collateral arteries. The angiograms should provide informat ion about the sources of the pulmonary blood supply and the d etail ed a n a tomy of the central pulmonary artery and of th e intrapulmona ry pulmona ry a rtery. Whe n th e MAPCAs are the sources of the pu lm onary blood supply , se lect i ve a ngiogr ap hy should be performed , because this *세 종병원 방사선과 * Depaγtmeη t 01 Radiology, Sejong General Hospital is essential for diagnosis and for d etermining operability and surgical approach. The angiography usually requires laye quantity of contrast materials and is a time-consuming procedure. If the angiographers know the sources of the pulmonary blood supply before cardioangiography , they may take appropriate a n giographic approach to save time . Although two-dimensional ech ocaridography is a good noninvas ive m ean of evaluatin g PA with VSD , it is limited in the e valuation of collateral blood supply. To authors' knowledge , although the

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“…3,5 However, it has been suggested that in these patients, the collaterals have lost their nutritive role to the lungs, being functionally "pulmonary" rather than "bronchial." 5,15,16 This assumption is based on the hypothesis that collateral arteries join the pulmonary arterial circulation at the hila or within the lungs before reaching the respiratory units and proximal to the origin of any nutritive end arteries. However, more recent anatomic descriptions 1,6,17 and our own observations in this study bring this view into question and demonstrate that collateral arteries may give branches to the tracheobronchial tree before they anastomose with the peripheral pulmonary circulation.…”

Section: Discussionmentioning

confidence: 99%

Severe Airflow Limitation After the Unifocalization Procedure : Clinical and Morphological Correlates

Schulze‐Neick

Ho²,

Bush³

et al. 2000

Circulation

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Background-While unifocalization techniques have improved the treatment options in patients with pulmonary atresia, ventricular septal defect (PA-VSD), and major aortopulmonary collaterals (MAPCAs), severe airflow limitation contributes to significant early postoperative morbidity and mortality. Although this has been attributed to bronchospasm, characteristically it is refractory to bronchodilators, suggesting that other mechanisms may play a role. Methods and Results-The clinical course and preoperative angiograms of patients who underwent unifocalization were reviewed. Patients who developed airflow limitation early after surgery underwent fiberoptic bronchoscopy. In addition, the anatomy of the MAPCAs was examined in 14 heart-lung blocks from patients with PA-VSD. Twenty-two procedures were performed in 16 children. Three developed marked airflow limitation early after surgery, necessitating prolonged high-pressure ventilation. Bronchoscopy demonstrated tracheobronchial epithelial necrosis in 2 and signs of tracheobronchial ischemia in the third. Two were successfully extubated after 15 and 16 days, but the third died after 57 days of ventilatory support. Review of the preoperative angiograms demonstrated an extensive peribronchial arterial supply arising from a MAPCA in 1 of the patients who developed severe airway necrosis after unifocalization. This was also obvious in a second patient, but the MAPCA was not included in the unifocalization. In 7 autopsy specimens, MAPCAs contributed to a peribronchial or peritracheal vascular network. Dissection of the distribution of these branches in 2 specimens revealed extensive intrapulmonary peribronchial anastomoses. Conclusions-Airflow

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Systemic arterial supply to the lungs in pulmonary atresia and its relation to pulmonary artery development.

Cited by 133 publications

References 7 publications

Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

The major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect: chest radiologic findings

Severe Airflow Limitation After the Unifocalization Procedure : Clinical and Morphological Correlates

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Systemic arterial supply to the lungs in pulmonary atresia and its relation to pulmonary artery development.

Cited by 133 publications

References 7 publications

Coronary Artery to Bronchial Artery Anastomosis in Takayasu&rsquo;s Arteritis

Coronary Artery to Bronchial Artery Anastomosis in Takayasu&rsquo;s Arteritis

The major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect: chest radiologic findings

Severe Airflow Limitation After the Unifocalization Procedure : Clinical and Morphological Correlates

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Product

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Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis