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Pulmonary Atresia with VSD and 'MAPCAs'

This defect is a form of Tetralogy of Fallot in which there is complete obstruction of the Pulmonary Artery resulting in total diversion of blood from the right ventricle into the aorta.  Survival depends on the presence of a number of naturally occurring connecting blood vessels between the Aorta and the Pulmonary Arteries in the lungs, which are called 'Collaterals' - or sometimes ‘MAPCAs’  (Major Aorto-Pulmonary Collateral Arteries).

 PA VSD absent pic1 PA VSD absent pic2 

The 'Collaterals' are usually several in number and carry blood to different parts of the lung circulation. Surgery is often a matter of connecting up the multiple Collaterals at different operations before performing a Complete Repair in suitable cases. The final 'Repair' usually involves insertion of a graft valve ('Conduit') to replace the absent Pulmonary Valve.

 PA VSD absent pic3  PA VSD absent pic4
After several procedures / operations to connect collaterals / pulmonary arteries and central 'shunt' Central shunt  After final complete repair with VSD closed and Conduit connecting RV to Pulmonary Artery Conduit VSD closed with patch 
 

Last Updated 02-Dec-2009. Authorised by: Jim Wilkinson. Enquiries: Adam Leadoux.
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