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In 40 patients had MAPCAs coiled in pre operative and 4 patients underwent MAPCAs coiling in postoperative period while having total correction of TOF.
Results: All the patients had successful occlusion of MAPCAs in post procedure time.
Conclusion: Transcatheter coil occlusion of MAPCAs is effective and hameodynamically beneficial interventional therapy in patients of total correction for Tetralogy of Fallot.
Additional midmusculer VSD, anomalies of coronary arteries, PAPVR (Partial anomalous pulmonary venous return) and major aortopulmonary collateral arteries (MAPCAs)2.
The association of MAPCAs with post operative TOF repair has resulted in morbidity and mortality in a pediatric intensive care unit.
One patient 18 years of age who had total correction, and remained in PICU for 13 weeks after total correction and improved significantly after MAPCAs were coiled.
The mayrid of shunts that includes residual VSD, residual MAPCAs, residual PDA, ASD have been closed in a cardiac interventional lab.
Li S et al reported that MAPCAs being a significant factor in prolonged mechanical ventilation times14 after total correction.
Post operative residual MAPCAs have resulted in congestive cardiac failure after total correction11,12.
MAPCAs can also be ligated during cardiac surgery but it takes longer time, results in blood loss and at times these vessels cannot be visualized in operating table.
However, PA-VSD- MAPCAs with hypoplastic PAs subgroup results are suboptimal and it carries high risk for reintervention.
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