Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report
Abstract Background The occurrence of major aortopulmonary collateral arteries (MAPCAs) is infrequent in patients with D-transposition of great arteries (D-TGA) with intact ventricular septum (IVS). Hemodynamically significant MAPCAs may complicate the postoperative course of these patients after ar...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-023-00349-2 |
| _version_ | 1797853753073729536 |
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| author | Gaser Abdelmohsen Naif AlKhushi Abdullah Alassiri Osman Al-Radi |
| author_facet | Gaser Abdelmohsen Naif AlKhushi Abdullah Alassiri Osman Al-Radi |
| author_sort | Gaser Abdelmohsen |
| collection | DOAJ |
| description | Abstract Background The occurrence of major aortopulmonary collateral arteries (MAPCAs) is infrequent in patients with D-transposition of great arteries (D-TGA) with intact ventricular septum (IVS). Hemodynamically significant MAPCAs may complicate the postoperative course of these patients after arterial switch operation (ASO). Case presentation We present a rare case of neonatal D-TGA-IVS associated with extensive MAPCAs. After the ASO, the patient developed pulmonary hemorrhage, chest wall edema, and deterioration of lung compliance with the need for high-frequency ventilation (HFV). The patient also had a significant capillary leak with skin edema, high chest tube drainage, and high peritoneal drainage. Cardiac catheterization revealed extensive MAPCAs supplying the whole lung segments. After the catheter closure of most of these MAPCAs, the patient had clinical improvement. Conclusions Although the occurrence of MAPCAs with D-TGA-IVS is infrequent, clinicians should suspect their presence in cases with unexplained heart failure, pulmonary hemorrhage, or cardiovascular compromise after ASO. Catheter closure of MAPCAs is feasible with an acceptable short-term outcome. |
| first_indexed | 2024-04-09T19:55:50Z |
| format | Article |
| id | doaj.art-ea07a1eb4b6643eab9da857b15718b2a |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-09T19:55:50Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-ea07a1eb4b6643eab9da857b15718b2a2023-04-03T05:31:36ZengSpringerOpenThe Egyptian Heart Journal2090-911X2023-03-017511510.1186/s43044-023-00349-2Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case reportGaser Abdelmohsen0Naif AlKhushi1Abdullah Alassiri2Osman Al-Radi3Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityFaculty of Medicine, King Abdulaziz UniversityCardiac Surgery Division, Department of Surgery, King Abdulaziz UniversityAbstract Background The occurrence of major aortopulmonary collateral arteries (MAPCAs) is infrequent in patients with D-transposition of great arteries (D-TGA) with intact ventricular septum (IVS). Hemodynamically significant MAPCAs may complicate the postoperative course of these patients after arterial switch operation (ASO). Case presentation We present a rare case of neonatal D-TGA-IVS associated with extensive MAPCAs. After the ASO, the patient developed pulmonary hemorrhage, chest wall edema, and deterioration of lung compliance with the need for high-frequency ventilation (HFV). The patient also had a significant capillary leak with skin edema, high chest tube drainage, and high peritoneal drainage. Cardiac catheterization revealed extensive MAPCAs supplying the whole lung segments. After the catheter closure of most of these MAPCAs, the patient had clinical improvement. Conclusions Although the occurrence of MAPCAs with D-TGA-IVS is infrequent, clinicians should suspect their presence in cases with unexplained heart failure, pulmonary hemorrhage, or cardiovascular compromise after ASO. Catheter closure of MAPCAs is feasible with an acceptable short-term outcome.https://doi.org/10.1186/s43044-023-00349-2Transposition of great arteriesAortopulmonary collateralsArterial switch operationMAPCAD-TGA |
| spellingShingle | Gaser Abdelmohsen Naif AlKhushi Abdullah Alassiri Osman Al-Radi Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report The Egyptian Heart Journal Transposition of great arteries Aortopulmonary collaterals Arterial switch operation MAPCA D-TGA |
| title | Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report |
| title_full | Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report |
| title_fullStr | Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report |
| title_full_unstemmed | Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report |
| title_short | Clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals, unusual condition but worth considering: case report |
| title_sort | clinical deterioration following arterial switch surgery due to extensive aortopulmonary collaterals unusual condition but worth considering case report |
| topic | Transposition of great arteries Aortopulmonary collaterals Arterial switch operation MAPCA D-TGA |
| url | https://doi.org/10.1186/s43044-023-00349-2 |
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