同: major aortopulmonary collateral arteries

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/29 00:42:16」(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]

Pathogenesis 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. Though it is usually associated with congenital heart diseases with decreased pulmonary blood flow like tetralogy of Fallot or pulmonary atresia it may be seen sometimes in isolation ie not associated with any congenital heart disease in that case it is termed as isolated aortopulmonary collateral artery.^[3] In these cases it may be one of the cause of congestive cardiac failure in neonates.^[4]

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 been oxygenated by the lungs, so are of little use in helping the body to get oxygen.

Associated conditions

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

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

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

Interactive videogame graphic showing repair of tetralogy of Fallot with pulmonary atresia - from Lucile Packard Children's Hospital Stanford & Lighthaus Inc.
Management of Tetralogy of Fallot with pulmonary atresia - contains angiographic images of MAPCAs.

References

^ 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. |access-date= 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.
^ http://ijmrhs.com/isolated-major-aortopulmonary-collateral-artery-causing-ccf-in-a-newborn-a-case-report/
^ Dr Mohammed Ashfaque, dr pallavi p saple, dr arpita et al http://ijmrhs.com/isolated-major-aortopulmonary-collateral-artery-causing-ccf-in-a-newborn-a-case-report/

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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

Development of Major Aorto-Pulmonary Collateral Arteries in Vegf120/120 Isoform Mouse Embryos with Tetralogy of Fallot.

Rammeloo LA1, DeRuiter MC, van den Akker NM, Wisse LJ, Gittenberger-de Groot AC.
Pediatric cardiology.Pediatr Cardiol.2014 Jul 29. [Epub ahead of print]
The degree of right ventricular outflow tract obstruction, pulmonary stenosis (PS) and the development of major aorto-pulmonary collateral arteries (MAPCAs) in patients with tetralogy of Fallot (TOF) is related to clinical outcome. Vegf120/120 mutant mouse embryos develop TOF with various degrees of
PMID 25070391

Risk Factors Associated with Prolonged Mechanical Ventilation after Corrective Surgery for Tetralogy of Fallot.

Li S1, Zhang Y, Li S, Wang X, Zhang R, Lu Z, Yan J.
Congenital heart disease.Congenit Heart Dis.2014 Jul 24. doi: 10.1111/chd.12205. [Epub ahead of print]
INTRODUCTION: This study examined early postoperative results to identify perioperative factors that are associated with prolonged mechanical ventilation (PMV) in tetralogy of Fallot (TOF) patients undergoing corrective surgery.METHODS: We retrospectively examined the role of perioperative variables
PMID 25059746

Tetralogy of Fallot: Aorto-pulmonary Collaterals And Pulmonary Arteries Have Distinctly Different Transcriptomes.

Ma X, Barboza LA, Siyahian A, Reinhartz O, Maeda K, Reddy VM, Hanley FL, Riemer RK.
Pediatric research.Pediatr Res.2014 Jul 7. doi: 10.1038/pr.2014.101. [Epub ahead of print]
Background:Tetralogy of Fallot patients with pulmonary atresia (TOF/PA) present a pulmonary blood supply directly from aortic collateral arteries. Major Aorta-Pulmonary Collateral Arteries (MAPCAs) present substantial clinical and surgical management challenges. Surgical operations to reestablish an
PMID 25000348

Japanese Journal

ファロー四徴症根治手術後左右シャント残存により心不全に陥ったが,コイル塞栓により著明に改善した1症例

木下真佐子,清水一好,戸田雄一郎 [他]
麻酔 59(11), 1441-1445, 2010-11
NAID 40017382637

Pulmonary Atresia With Ventricular Septal Defects and Major Aortopulmonary Collateral Arteries : 18-Year Clinical Experience and Angiographic Follow-up of Major Aortopulmonary Collateral Arteries(Pediatric Cardiology)

Song Suk-Won,Park Han Ki,Park Young-Hwan,Cho Bum Koo
Circulation journal : official journal of the Japanese Circulation Society 73(3), 516-522, 2009-02-20
… Background: There is no consensus on the long-term outcome after unifocalization in patients undergoing surgery for pulmonary atresia with ventricular septal defects (VSD) and major aortopulmonary collateral arteries (MAPCAs). … Methods and Results: From 1988 to 2006, 40 patients (median age 8.5 months) underwent surgery for pulmonary atresia, VSD, and MAPCAs. …
NAID 110007126725

Related Pictures

Mapca 1 Heart defect: tetralogy of fallot--ventricular septal defect, enlarged aorta 23 best Major Aortopulmonary Collateral Artery (MAPCAs) images on Pinterest Cardiology : Pulmonary Atresia with VSD and MAPCAs Pulmonary Atresia with Major Aortopulmonary Collateral Arteries (MAPCA's), or Pulmonary Atresia With Mapcas Pictures to Pin on Pinterest - PinsDaddy