Postoperative coil embolization of residual MAPCAs greatly improved left heart failure in a patient after corrective surgery for pulmonary atresia, ventricular septal defect and MAPCAs

Masako Kinoshita, Kazuyoshi Shimizu, Yuichiro Toda, Satoshi Suzuki, Tomohiko Suemori, Tatsuo Iwasaki, Toru Takahashi, Kiyoshi Morita

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A male child, aged 1 year, with pulmonary atresia, ventricular septal defect and major aorto-pulmonary collateral arteries (PA, VSD, MAPCA) underwent corrective surgery including MAPCA ligation uneventfully. A few hours after admission to the ICU, severe heart failure, refractory to aggressive cardiac support including epinephrine infusion, became worse. Emergent cardiac catheterization on postoperative day 5 demonstrated the residual MAPCA and its occlusion by coil embolization dramatically resolved heart failure, indicating that the primary cause of this hemodynamic instability was likely excessive left-to-right shunt due to MAPCA. Residual LR shunt should be kept in mind to be a rare but significant cause of postoperative serious heart failure.

Original languageEnglish
Pages (from-to)1441-1445
Number of pages5
JournalJapanese Journal of Anesthesiology
Volume59
Issue number11
Publication statusPublished - Nov 10 2010

Keywords

  • Coil embolization
  • Major aorto-pulmonary collateral arteries
  • Tetralogy of Fallot

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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