title: [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].
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.
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama 700-8558.
authors.forename: Masako
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Toda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Suemori
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
mesh_terms: D001011:Aorta / Q000002:abnormalities; D003097:Collateral Circulation; D004621:Embolization, Therapeutic; D006333:Heart Failure / Q000628:therapy*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities; D018633:Pulmonary Atresia / Q000601:surgery; D013771:Tetralogy of Fallot / Q000601:surgery*