title: Tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral vessels.
abstract: Major aortopulmonary collateral arteries (MAPCAs) provide significant issues during cardiopulmonary bypass, including flooding of the surgical field which requires significant blood volumes to be returned to the extracorporeal circuit via handheld suckers. This has been shown to be the major source of gaseous microemboli and is associated with adverse neurological outcome. Use of pH-stat has been previously shown to decrease the shunt through MAPCAs via an unknown mechanism. Here, we report the associated benefits of pH-stat in decreasing sucker usage and gaseous microemboli in a patient with known MAPCAs presenting for repair of tetralogy of Fallot and pulmonary atresia.
authors.affiliation: Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK Institute of Cardiovascular Science, University College London, UK richard.issitt@gosh.nhs.uk.
authors.forename: R W
authors.initials: RW
authors.lastname: Issitt
authors.affiliation: Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Robertson
authors.affiliation: Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Crook
authors.affiliation: Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Cross
authors.affiliation: Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Shaw
authors.affiliation: Institute of Cardiovascular Science, University College London, UK Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK.
authors.forename: V T
authors.initials: VT
authors.lastname: Tsang
mesh_terms: D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D007223:Infant; D018633:Pulmonary Atresia / Q000150:complications / Q000473:pathology / Q000601:surgery; D013771:Tetralogy of Fallot / Q000150:complications / Q000473:pathology / Q000601:surgery
keywords: CHD; CPB; cardiac anatomy/pathologic anatomy; collateral blood flow (lungs); embolism (gaseous); physiology/pathophysiology; tetralogy of Fallot