CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(04): 496-507
DOI: 10.1055/s-0043-1770344
Review Article

Basic Concepts and Insights into Aortopulmonary Collateral Arteries in Congenital Heart Diseases

1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Akash Vadher*
2   Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
,
Manish Shaw
2   Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
,
Amarinder S. Malhi
2   Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
,
Sanjeev Kumar
2   Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
,
1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Funding None.

Abstract

Aortopulmonary collateral arteries are persistent embryological vessels supplying lung parenchyma in various cardiopulmonary diseases with underlying pulmonary hypoperfusion. Their identification and mapping are important because of associated clinical implications and tendency to affect the surgical outcome. This article describes the embryological development and clinical relevance of aortopulmonary collaterals in various congenital cardiopulmonary conditions, along with the significance for treatment planning. Roles, strength, and shortcomings of the various imaging options and image-guided interventions are discussed, with a focus on presurgical planning and preparation, as well as postsurgical management.

* Co-first author




Publication History

Article published online:
14 July 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Boyden EA. The time lag in the development of bronchial arteries. Anat Rec 1970; 166 (04) 611-614
  • 2 Boshoff D, Gewillig M. A review of the options for treatment of major aortopulmonary collateral arteries in the setting of tetralogy of Fallot with pulmonary atresia. Cardiol Young 2006; 16 (03) 212-220
  • 3 Alex A, Ayyappan A, Valakkada J, Kramadhari H, Sasikumar D, Menon S. Major aortopulmonary collateral arteries. Radiol Cardiothorac Imaging 2022; 4 (01) e210157
  • 4 Nørgaard MA, Alphonso N, Cochrane AD, Menahem S, Brizard CP, d'Udekem Y. Major aorto-pulmonary collateral arteries of patients with pulmonary atresia and ventricular septal defect are dilated bronchial arteries. Eur J Cardiothorac Surg 2006; 29 (05) 653-658
  • 5 Hanley FL. MAPCAs, bronchials, monkeys, and men. Eur J Cardiothorac Surg Germany 2006; 29 (05) 643-644
  • 6 Mainwaring RD, Reddy VM, Peng L, Kuan C, Palmon M, Hanley FL. Hemodynamic assessment after complete repair of pulmonary atresia with major aortopulmonary collaterals. Ann Thorac Surg 2013; 95 (04) 1397-1402
  • 7 Haworth SG. Collateral arteries in pulmonary atresia with ventricular septal defect. A precarious blood supply. Br Heart J 1980; 44 (01) 5-13
  • 8 Haworth SG, Macartney FJ. Growth and development of pulmonary circulation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Br Heart J 1980; 44 (01) 14-24
  • 9 Jia Q, Cen J, Li J. et al. Anatomy of the retro-oesophageal major aortopulmonary collateral arteries in patients with pulmonary atresia with ventricular septal defect: results from preoperative CTA. Eur Radiol 2018; 28 (07) 3066-3074
  • 10 Mainwaring RD, Patrick WL, Carrillo SA, Ibrahimye AN, Muralidaran A, Hanley FL. Prevalence and anatomy of retroesophageal major aortopulmonary collateral arteries. Ann Thorac Surg 2016; 102 (03) 877-882
  • 11 Sharma A, Kumar S, Priya S. Ruptured aneurysm of major aortopulmonary collateral artery: management using Amplatzer vascular plug. Cardiovasc Diagn Ther 2016; 6 (03) 274-277
  • 12 Patrick WL, Mainwaring RD, Reinhartz O, Punn R, Tacy T, Hanley FL. Major aortopulmonary collateral arteries with anatomy other than pulmonary atresia/ventricular septal defect. Ann Thorac Surg 2017; 104 (03) 907-916
  • 13 Presnell LB, Blankenship A, Cheatham SL, Owens GE, Staveski SL. An overview of pulmonary atresia and major aortopulmonary collateral arteries. World J Pediatr Congenit Heart Surg 2015; 6 (04) 630-639
  • 14 Sharma S, Kothari SS, Krishnakumar R. et al. Systemic-to-pulmonary artery collateral vessels and surgical shunts in patients with cyanotic congenital heart disease: perioperative treatment by transcatheter embolization. Am J Roentgenol 1995; 164 (06) 1505-1510
  • 15 Permut LC, Laks H, Aharon A. Surgical management of pulmonary atresia with ventricular septal defect and multiple aortopulmonary collaterals. Isr J Med Sci 1994; 30 (03) 215-224
  • 16 Latus H, Gummel K, Diederichs T. et al. Aortopulmonary collateral flow is related to pulmonary artery size and affects ventricular dimensions in patients after the Fontan procedure. PLoS One 2013; 8 (11) e81684
  • 17 Lloyd DFA, Goreczny S, Austin C. et al. Catheter, MRI and CT imaging in newborns with pulmonary atresia with ventricular septal defect and aortopulmonary collaterals: quantifying the risks of radiation dose and anaesthetic time. Pediatr Cardiol 2018; 39 (07) 1308-1314
  • 18 Westra SJ, Hill JA, Alejos JC, Galindo A, Boechat MI, Laks H. Three-dimensional helical CT of pulmonary arteries in infants and children with congenital heart disease. Am J Roentgenol 1999; 173 (01) 109-115
  • 19 Taneja K, Sharma S, Kumar K, Rajani M. Comparison of computed tomography and cineangiography in the demonstration of central pulmonary arteries in cyanotic congenital heart disease. Cardiovasc Intervent Radiol 1996; 19 (02) 97-100
  • 20 Smettei OA, Sayed S, M Al Habib A, Alharbi F, Abazid RM. Ultra-fast, low dose high-pitch (FLASH) versus prospectively-gated coronary computed tomography angiography: Comparison of image quality and patient radiation exposure. J Saudi Heart Assoc 2018; 30 (03) 165-171
  • 21 M Abazid R, A Smettei O, F Eldesoky A, et al. Non-gated triple flash coronary computed tomographic angiography in patients with atrial fibrillation. Zhonghua Minguo Xinzangxue Hui Zazhi 2018; 34 (04) 352-358
  • 22 Qu TT, Li JY, Jiao XJ. et al. Contrast dose reduction with shortened injection durations in coronary CT angiography on 16-cm Wide-detector CT scanner. Br J Radiol 2018; 91 (1092): 20180580
  • 23 Vasconcelos R, Vrtiska TJ, Foley TA. et al. Reducing iodine contrast volume in CT angiography of the abdominal aorta using integrated tube potential selection and weight-based method without compromising image quality. Am J Roentgenol 2017; 208 (03) 552-563
  • 24 Yin L, Lu B, Han L. et al. Quantitative analysis of pulmonary artery and pulmonary collaterals in preoperative patients with pulmonary artery atresia using dual-source computed tomography. Eur J Radiol 2011; 79 (03) 480-485
  • 25 Prasad SK, Soukias N, Hornung T. et al. Role of magnetic resonance angiography in the diagnosis of major aortopulmonary collateral arteries and partial anomalous pulmonary venous drainage. Circulation 2004; 109 (02) 207-214
  • 26 Rao UV, Vanajakshamma V, Rajasekhar D, Lakshmi AY, Reddy RN. Magnetic resonance angiography vs. angiography in tetralogy of Fallot. Asian Cardiovasc Thorac Ann 2013; 21 (04) 418-425
  • 27 Nael K, Michaely HJ, Kramer U. et al. Pulmonary circulation: contrast-enhanced 3.0-T MR angiography–initial results. Radiology 2006; 240 (03) 858-868
  • 28 Edelman RR, Silvers RI, Thakrar KH. et al. Nonenhanced MR angiography of the pulmonary arteries using single-shot radial quiescent-interval slice-selective (QISS): a technical feasibility study. J Cardiovasc Magn Reson 2017; 19 (01) 48
  • 29 Edelman RR, Giri S, Pursnani A, Botelho MP, Li W, Koktzoglou I. Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla. J Cardiovasc Magn Reson 2015; 17: 101
  • 30 Fogel MA. Principles and Practice of Cardiac Magnetic Resonance in Congenital Heart Disease: Form, Function, and Flow. Wiley-Blackwell, United Kingdom; 2010
  • 31 Grosse-Wortmann L, Yoo S-J, van Arsdell G. et al. 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. J Thorac Cardiovasc Surg 2013; 146 (05) 1185-1190
  • 32 Mainwaring RD, Margetson TD, McCarthy P. et al. Measurement of residual collateral flow in pulmonary atresia with major aortopulmonary collaterals. Ann Thorac Surg 2019; 108 (01) 154-159
  • 33 Azarine A, Garçon P, Stansal A. et al. Four-dimensional flow MRI: principles and cardiovascular applications. Radiographics 2019; 39 (03) 632-648
  • 34 Vishnevskiy V, Walheim J, Kozerke S. Deep variational network for rapid 4D flow MRI reconstruction. Nat Mach Intell 2020; 2 (04) 228-235
  • 35 Geva T, Greil GF, Marshall AC, Landzberg M, Powell AJ. Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia: comparison with X-ray angiography. Circulation 2002; 106 (04) 473-478
  • 36 Wagner LK, Pollock JJ. Real-time portal monitoring to estimate dose to skin of patients from high dose fluoroscopy. Br J Radiol 1999; 72 (861) 846-855
  • 37 den Boer A, de Feijter PJ, Serruys PW, Roelandt JR. Real-time quantification and display of skin radiation during coronary angiography and intervention. Circulation 2001; 104 (15) 1779-1784
  • 38 Haddad L, Waller BR, Johnson J. et al. Radiation protocol for three-dimensional rotational angiography to limit procedural radiation exposure in the pediatric cardiac catheterization lab. Congenit Heart Dis 2016; 11 (06) 637-646
  • 39 Mackie AS, Gauvreau K, Perry SB, del Nido PJ, Geva T. Echocardiographic predictors of aortopulmonary collaterals in infants with tetralogy of Fallot and pulmonary atresia. J Am Coll Cardiol 2003; 41 (05) 852-857
  • 40 Wipf A, Christmann M, Navarini-Meury S. et al. Aortopulmonary collaterals in neonates with d-transposition of the great arteries - clinical significance early after arterial switch operation. Int J Cardiol 2018; 258: 237-242
  • 41 Lofland GK. The management of pulmonary atresia, ventricular septal defect, and multiple aorta pulmonary collateral arteries by definitive single stage repair in early infancy. Eur J Cardiothorac Surg 2000; 18 (04) 480-486
  • 42 Reddy VM, Liddicoat JR, Hanley FL. Midline one-stage complete unifocalization and repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals. J Thorac Cardiovasc Surg 1995; 109 (05) 832-844 , discussion 844–845
  • 43 Ma M, Mainwaring RD, Hanley FL. Comprehensive management of major aortopulmonary collaterals in the repair of tetralogy of Fallot. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018; 21: 75-82
  • 44 Hofferberth SC, Esch JJ, Zurakowski D, Baird CW, Mayer JE, Emani SM. Pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: collateral vessel disease burden and unifocalisation strategies. Cardiol Young 2018; 28 (09) 1091-1098
  • 45 Mainwaring RD, Patrick WL, Roth SJ. et al. Surgical algorithm and results for repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals. J Thorac Cardiovasc Surg 2018; 156 (03) 1194-1204
  • 46 Ikai A. Surgical strategies for pulmonary atresia with ventricular septal defect associated with major aortopulmonary collateral arteries. Gen Thorac Cardiovasc Surg 2018; 66 (07) 390-397
  • 47 Reinhartz O, Reddy VM, Petrossian E. et al. Unifocalization of major aortopulmonary collaterals in single-ventricle patients. Ann Thorac Surg 2006; 82 (03) 934-938 , discussion 938–939
  • 48 Vaikunth SS, Bauser-Heaton H, Lui GK. et al. Repair of untreated older patients with tetralogy of Fallot with major aortopulmonary collaterals. Ann Thorac Surg 2019; 107 (04) 1218-1224
  • 49 Iyer KS, Mee RB. Staged repair of pulmonary atresia with ventricular septal defect and major systemic to pulmonary artery collaterals. Ann Thorac Surg 1991; 51 (01) 65-72
  • 50 Barbero-Marcial M, Jatene AD. Surgical management of the anomalies of the pulmonary arteries in the tetralogy of Fallot with pulmonary atresia. Semin Thorac Cardiovasc Surg 1990; 2 (01) 93-107
  • 51 Sawatari K, Imai Y, Kurosawa H, Isomatsu Y, Momma K. Staged operation for pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries. New technique for complete unifocalization. J Thorac Cardiovasc Surg 1989; 98 (5 Pt 1): 738-750
  • 52 Soquet J, Liava'a M, Eastaugh L. et al. Achievements and limitations of a strategy of rehabilitation of native pulmonary vessels in pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries. Ann Thorac Surg 2017; 103 (05) 1519-1526
  • 53 Gupta A, Odim J, Levi D, Chang R-K, Laks H. Staged repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries: experience with 104 patients. J Thorac Cardiovasc Surg 2003; 126 (06) 1746-1752
  • 54 McElhinney DB, Reddy VM, Hanley FL. Tetralogy of Fallot with major aortopulmonary collaterals: early total repair. Pediatr Cardiol 1998; 19 (04) 289-296
  • 55 Anderson RH. Paediatric Cardiology. 2nd ed. ed.. London: Churchill Livingstone; 2002
  • 56 Rao PS. Transcatheter embolization of unwanted blood vessels in children. In: Rao PS, Ker MJ. eds. Catheter Based Devices for the Treatment of Non-coronary Cardiovascular Disease in Adults and Children. Philadelphia: Lippincott Williams & Wilkins; 2003: 457-73
  • 57 Hui F, Fiorella D, Masaryk T, Rasmussen P, Dion J. A history of detachable coils: 1987–2012. J Neurointerv Surg 2013; •••: 6
  • 58 Shellock FG, Gounis M, Wakhloo A. Detachable coil for cerebral aneurysms: in vitro evaluation of magnetic field interactions, heating, and artifacts at 3T. AJNR Am J Neuroradiol 2005; 26 (02) 363-366
  • 59 Baker CM, McGowan Jr FX, Keane JF, Lock JE. Pulmonary artery trauma due to balloon dilation: recognition, avoidance and management. J Am Coll Cardiol 2000; 36 (05) 1684-1690
  • 60 Redington AN, Somerville J. Stenting of aortopulmonary collaterals in complex pulmonary atresia. Circulation 1996; 94 (10) 2479-2484
  • 61 El-Said HG, Clapp S, Fagan TE, Conwell J, Nihill MR. Stenting of stenosed aortopulmonary collaterals and shunts for palliation of pulmonary atresia/ventricular septal defect. Catheter Cardiovasc Interv 2000; 49 (04) 430-436
  • 62 Olejnik P, Tittel P, Venczelova Z, Masura J. Stenting of stenotic aortopulmonary collaterals in non-surgically treated adolescent or adult patients with pulmonary atresia, ventricular septal defect and multiple aortopulmonary collaterals. Bratisl Lek Listy 2016; 117 (02) 72-76