Morphological Characteristics Of Major Aortopulmonary Collateral Arteries In Complex Congenital Heart Disease

Objective To investigate the morphological characteristics of major aortopulmonarycollateral arteries (MAPCAs) in complex congenital heart disease (CHD). MethodsWe retrospectively analyzed the imaging data of CHD with MAPCAs. Thedistribution, number and the morphological characteristics of MAPCAs weresummarized. Results Our patient cohort included51patients of CHD with MAPCAs.Among them,33patients (64.71%) were pulmonary atrsia/ventricular septal defect,11(21.57%) were tetralogy of Fallot,2(3.92%) were double outlet right ventricle,1(1.96%) was complete transposition of the great arteries,1(1.96%) was completeatrioventricular septal defect,1(1.96%) was pulmonary stenosis,1(1.96%) waspulmonary artery sling,1(1.96%) was absence of pulmonary artery. Besides,16patients (31.37%) had patent ductus arteriosus. In this group, central pulmonaryarteries and confluent were present in43patients (84.31%). Totally,117MAPCAswere founded in51patients,1~6per patients, mean2.29per patients. Theirs openingdiameter were2.0~18.0mm, mean4.3mm. There were16MAPCAs (13.68%) fromaortic arch,75(64.10%) from thoracic descending aorta,2(1.71%) frombrachiocephalic artery,11(9.40%) from right subclavian artery,12(10.26%) fromleft subclavian artery, and1(0.85%) from other rare arteries. Three MAPCAs(2.56%) had narrowed in opening and followed by dilation, and57MAPCAs(48.72%) had squirm twist before turned into lungs. MAPCAs were the only supply of relative lung lobes in8patients (15.96%). Besides,13MAPCAs (11patients withpulmonary artesia/ventricular septal defect) had their branches, with larger openingdiameter. The number of MAPCAs branches were2~4, usually2. The MAPCAstypes included group â…¡ for91MAPCAs (77.78%), group â…¢ for26MAPCAs(22.22%), group â… was none. Conclusion MAPCAs were highly variable in theirorigin, number, size, course and arborization. It mainly impacted on the choice ofoperations. It was very important to know about the distribution and morphologicalcharacteristics of MAPCAs.