Arévalo-Salas LA, Lacayo-Molina AL, Villatoro-Fernández JL, Lozano-Díaz RA, Bolio-Cerdán A, Erdmenger-Orellana J

Language: Spanish
References: 13
Page: 310-313
PDF size: 89.10 Kb.

ABSTRACT

Background. Pulmonary atresia with ventricular septal defect (VSD) is a complex heart disease with an incidence of ~2% of all congenital heart diseases. It is frequently associated with 22q11 deletion syndrome. Due to extensive anatomic variability, it is necessary to accurately establish an individualized surgical/medical plan.
Case report. We report the case of a 2-year-old patient with pulmonary atresia and two associated large septal aortopulmonary collaterals. This patient underwent Rastelli surgery at which time it was possible to ligate one of the collateral arteries. The remaining were embolized by transcatheter device with total occlusion.
Conclusions. Management of collateral arteries associated with pulmonary atresia with VSD is complex but is accessible with transcatheter treatment with device implantation and with minimal morbidity.

REFERENCES

1. O’Leary P, Mair D, Edwards W, Julsrud P, Puga F. Pulmonary atresia and ventricular septal defect. En: Allen H, Gutgesell H, Clark E, Driscoll D, eds. Moss and Adams’ Heart Disease in Infants, Children and Adolescents. Including the Fetus and Young Adult. Philadelphia: Lippincott, Williams and Wilkins; 2001. pp. 864-879.

2. McGoon MD, Fulton RE, Davis GD, Ritter DG, Neill CA, White RI Jr. Systemic collateral and pulmonary artery stenosis in patients with congenital pulmonary valve atresia and ventricular septal defect. Circulation 1977;56:473-479.

3. Hoffman J: Tetralogy of Fallot with pulmonary atresia. En: Hoffman J, ed. The Natural and Unnatural History of Congenital Heart Disease. West Sussex: Wiley-Blackwell; 2009. pp. 437-445.

4. Tchervenkov CI, Roy N. Congenital Heart Surgery Nomenclature and Database Project: pulmonary atresia—ventricular septal defect. Ann Thorac Surg 2000;69(suppl 4):S97-S105.

5. Frohn-Mulder IM, Wesby Swaay E, Bouwhuis C, Van Hemel JO, Gerritsma E, Niermeyer MF, et al. Chromosome 22q11 deletions in patients with selected outflow tract malformations. Genet Couns 1999;10:35-41.

6. Boshoff D, Gewillig M. A review of the options for treatment of major aortopulmonary collateral arteries in the setting of tetralogy of Fallot with pulmonary atresia. Cardiol Young 2006;16:212-220.

7. Seok Bang J, Suk Baek J, Zhu L, Bae E, Il Noh Ch, Choi JY, et al. Pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries: management strategy at our hospital and the results. Korean Circulation J 2007;37:348-352.

8. Balaguru D, Dilawar M. Pulmonary atresia with ventricular septal defect: systematic review. Heart Views 2005;8:52-61.

9. Gupta A, Odim J, Levi D, Chang RK, Laks H. Staged repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries: experience with 104 patients. J Thorac Cardiovasc Surg 2003;126:1746-1752.

10. Rao P. Transcatheter embolization of unwanted blood vessels in children. En: Rao P, Kern M, eds. Catheter Based Devices for the Treatment of Non-coronary Cardiovascular Disease in Adults and Children. Philadelphia: Lippincot Wiliams & Wilkins; 2003. pp. 457-473.

11. Küçükay F, Sarper R, Cumhur T. Three huge pulmonary arteriovenous malformations: endovascular embolization with the Amplatzer vascular plug. Tur Toraks Der 2011;12:168-171.

12. Wang W, Li H, Tam MD, Zhou D, Wang DX, Spain J. The Amplatzer vascular plug: a review of the device and its clinical applications. Cardiovasc Intervent Radiol 2012;35:725-740.

13. Sureka A, Peng L, Reinhartz O, Reddy M, Hanley M. Anatomy in patients with 22q11 deletion and pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals. Surg Sci 2011;2:294-296.