Major aortopulmonary collateral artery

Major aortopulmonary collateral arteries (or MAPCAs) are arteries that develop to supply blood to the lungs when native pulmonary circulation is underdeveloped. Instead of coming from the pulmonary trunk, supply develops from the aorta and other systemic arteries.^[1]

Pathologenesis and anatomy

Major aortopulmonary collateral arteries (MAPCAs) develop early in embryonic life but regress as the normal pulmonary arteries (vessels that will supply deoxygenated blood to the lungs) develop.^[2] In certain heart conditions the pulmonary arteries do not develop. The collaterals continue to grow, and can become the main supply of blood to the lungs.

Pulmonary arteries come from the right side of the heart, and usually carry deoxygenated blood from the body. These collateral arteries carry blood which has already be oxygenated by the lungs, so are of little use in helping the body to get oxygen.

Conditions associated with MAPCAs

Pulmonary atresia with an intact ventricular septum (or Tetralogy of Fallot with pulmonary atresia will result in the development of systemic collaterals.

Implications of a systemic collateral supply

Major aortopulmonary collateral arteries come from the systemic circulation, because of this they will often have higher pressure than normal found in the lungs leading to pulmonary hypertension. These vessels are not programmed to exist beyond early fetal life, and eventually became narrowed and stenotic.^[2]

Treatment of MAPCAs

The aim of treatment of the MAPCAs is to group them together and convert their supply to deoxygenated blood from the right side of the heart.

External links

• Management of Tetralogy of Fallot with pulmonary atresia - contains angiographic images of MAPCAs.

References

1. ^ Maeda, Eriko; Masaaki Akahane, Nobuyuki Kato, Naoto Hayashi, Hisao Koga, Haruyasu Yamada, Hitoshi Kato, Kuni Ohtomo (2006-06-01). "Assessment of major aortopulmonary collateral arteries with multidetector-row computed tomography". Radiation Medicine 24 (5): 378–383. doi:10.1007/s11604-006-0037-y. 
2. ^ ^{a b} Boshoff, Derize; Marc Gewillig (2006). "A review of the options for treatment of major aortopulmonary collateral arteries in the setting of tetralogy of Fallot with pulmonary atresia". Cardiology in the Young 16 (03): 212. doi:10.1017/S1047951106000606. ISSN 1047-9511. http://www.britannica.com/bps/additionalcontent/18/21100835/A-review-of-the-options-for-treatment-of-major-aortopulmonary-collateral-arteries-in-the-setting-of-tetralogy-of-Fallot-with-pulmonary-atresia. Retrieved 2010-03-21.