Rehabilitation of Pulmonary Arteries in Pulmonary Atresia, VSD and Mapcas

Abstract

Patients with pulmonary atresia, Ventricular septal defect (VSD), and Major Aorto Pulmonary Collateral Arteries have a lung circulation depending primarily from perfusion by collateral arteries. A large proportion of them will have central pulmonary vessels connected to a variable proportion of segmental pulmonary vessels. A strategy of rehabilitation of central pulmonary vessels consist in the realization of shunts and conduits between the aorta or the right ventricle and these central vessels in order to obtain a dilatation of these vessels to assist the reconstruction of a pulmonary vascularization. Repetitive patch reconstruction of the central pulmonary vessels or even their replacement are often necessary. Additional procedural steps may be needed at the time of the repair to reconnect to the central pulmonary circulation large intrapulmonary vessels dependent of collateral flow.