同: major aorto-pulmonary collateral artery

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/05/09 10:39:42」(JST)

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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 [edit]

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 [edit]

Pulmonary atresia with ventricular septal defect (or Tetralogy of Fallot with pulmonary atresia will result in the development of systemic collaterals.)

Implications of a systemic collateral supply [edit]

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 [edit]

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 [edit]

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

References [edit]

^ 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. |accessdate= requires |url= (help)
^ ^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. Retrieved 2010-03-21.

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1. 肺閉鎖症および主要大動脈肺動脈側副動脈（TOF/ PA/ MAPCA）を伴うファロー四徴症 tetralogy of fallot with pulmonary atresia and major aortopulmonary collateral arteries tof pa mapcas

English Journal

Preoperative total pulmonary blood flow predicts right ventricular pressure in patients early after complete repair of tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries.

Grosse-Wortmann L1, Yoo SJ, van Arsdell G, Chetan D, Macdonald C, Benson L, Honjo O.
The Journal of thoracic and cardiovascular surgery.J Thorac Cardiovasc Surg.2013 Nov;146(5):1185-90. doi: 10.1016/j.jtcvs.2013.01.032. Epub 2013 Feb 12.
OBJECTIVE: The management of patients with tetralogy of Fallot (ToF) and pulmonary atresia (PA) with major aortopulmonary collateral arteries (MAPCAs) is challenging. Frequently it is difficult to predict whether complete repair with closure of the ventricular septal defect (VSD) will be tolerated.
PMID 23414777

Surgical reconstruction of pulmonary stenosis with ventricular septal defect and major aortopulmonary collaterals.

Mainwaring RD1, Punn R, Reddy VM, Hanley FL.
The Annals of thoracic surgery.Ann Thorac Surg.2013 Apr;95(4):1417-21. doi: 10.1016/j.athoracsur.2013.01.007. Epub 2013 Feb 21.
BACKGROUND: Pulmonary stenosis with ventricular septal defect and major aortopulmonary collaterals (PS/VSD/MAPCAs) is an extremely rare form of congenital heart defect. Although it has been assumed that PS/VSD/MAPCAs would be similar to pulmonary atresia (PA) with VSD/MAPCA, there are currently no d
PMID 23434256

Treatment of segmental pulmonary artery hypertension in adults with congenital heart disease.

Schuuring MJ1, Bouma BJ, Cordina R, Gatzoulis MA, Budts W, Mullen MP, Vis JC, Celermajer D, Mulder BJ.
International journal of cardiology.Int J Cardiol.2013 Mar 20;164(1):106-10. doi: 10.1016/j.ijcard.2011.06.084. Epub 2011 Jul 18.
INTRODUCTION: Pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD) usually has a homogeneous pressure distribution. More rarely, complex CHD patients have segmental PAH. This is often post-surgically. The characteristics of these patients and their responsiveness to
PMID 21763017

Japanese Journal

主要体肺動脈側副血行を有する肺動脈欠損兼心室中隔欠損に対する痕跡的中心肺動脈の術中直接造影

杉本愛,藤本欣史,太田教隆 [他]
胸部外科 65(5), 369-373, 2012-05
NAID 40019302680

127) 両大血管右室起始症・肺動脈閉鎖症・MAPCAに対し姑息的Rastelli手術施行後に41歳時に根治術施行した1例(第104回日本循環器学会九州地方会)

佐々利明,三隅寛恭,平山統一,上杉英之,出田一郎,森元博信,宮本卓馬
Circulation journal : official journal of the Japanese Circulation Society 72(Supplement_III), 1127, 2008-10-20
NAID 110007011591

Related Pictures

Pulmonary Atresia with VSD and MAPCAs repair mapca-from-rima-1 This is a heart with Pulmonary Atresia VSD in the normal heart desaturated blood copyright policy mapca