EFFECT OF EMBOLIZATION OF MAJOR AORTOPULMONARY COLLATERAL ARTERIES ONCARDIOPULMONARY CIRCULATION IN CONGENITAL HEART-DISEASE - ASSESSMENT WITH LUNG PERFUSION SCAN

Citation
Y. Okuda et al., EFFECT OF EMBOLIZATION OF MAJOR AORTOPULMONARY COLLATERAL ARTERIES ONCARDIOPULMONARY CIRCULATION IN CONGENITAL HEART-DISEASE - ASSESSMENT WITH LUNG PERFUSION SCAN, Vascular surgery, 29(3), 1995, pp. 199-207
Citations number
NO
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Peripheal Vascular Diseas
Journal title
ISSN journal
00422835
Volume
29
Issue
3
Year of publication
1995
Pages
199 - 207
Database
ISI
SICI code
0042-2835(1995)29:3<199:EOEOMA>2.0.ZU;2-T
Abstract
Major aortopulmonary collateral arteries (MAPCAs) may affect pulmonary hemodynamics significantly in patients with cyanotic congenital heart diseases. Occluding such collateral arteries is expected not only to diminish systemic-to-pulmonary shunt but also to increase pulmonary pe rfusion via the central pulmonary artery. The authors performed coil e mbolization of MAPCAs communicating with the central pulmonary artery or its branches in 3 patients aged from three to fifteen years (2: tet ralogy of Fallot, 1: pulmonary atresia with ventricular septal defect) . On chest roentgenogram, the cardiac size diminished after embolizati on in 2 subjects owing probably to decreased systemic-to-pulmonary blo od flow. The pulmonary perfusion scintigram with Tc 99m macroaggregate d albumin.-was performed before and after embolization, Before emboliz ation, multiple segmental or lobar perfusion defects or hypoperfusion areas were observed in all cases. After embolization, however, the sci ntigrams unexpectedly did not show any improvement. These results sugg est that the occlusion of MAPCAs is effective in decreasing systemic-t o-pulmonary blood flow but not effective in increasing lung perfusion. The authors speculate that obliterative and irreversible pulmonary va scular damages might have occurred in all cases.