title: Aortopulmonary collateral artery in prenatal exposure to carbamazepine - endovascular therapy and technical considerations: a case report.
abstract: BACKGROUND
  Aortopulmonary collateral arteries are an uncommon variant of alternative blood supply in cases of complex congenital heart disease. Although surgery may still be the classic approach for this condition, mini-invasive endovascular occlusion has been recently attempted as an alternative less traumatic procedure. Children born to women with epilepsy are at increased risk of congenital malformations.
  
  
  METHODS
  A cardiovascular malformation in a 6-year-old white boy with prenatal exposure to carbamazepine is described. At birth, he underwent atrial-ventricular septal defects repair. At 6 years of age, he was diagnosed to have an aberrant aortopulmonary artery from the descending aorta. He presented with recurrent respiratory infections and no cardiovascular signs, but there was associated right upper lobe hyperperfusion. Collateral percutaneous plug embolization was performed because of risk for cardiorespiratory infections, pulmonary hypertension and atrioventricular dilatation. The post-releasing control showed a complete occlusion of the aberrant artery. A chest radiogram and computed tomography showed normalization of vascular pattern of his right lung at 9-months follow-up. No complications and no respiratory infections in the first follow-up year were observed. A good growth gain was obtained.
  
  
  CONCLUSIONS
  Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms. Management and long-term pediatric multidisciplinary follow-up is recommended. Prenatal exposure to carbamazepine could be considered in the pathogenesis and diagnosis of the malformation.
authors: Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia, P.le Golgi n.2, 27100, Pavia, Italy. g.pelizzo@smatteo.pv.it.
authors: Gloria
authors: G
authors: Pelizzo
authors: Department of the Mother and Child Health, Pediatric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. v.calcaterra@smatteo.pv.it.|Department of Internal Medicine, University of Pavia, Pavia, Italy. v.calcaterra@smatteo.pv.it.
authors: Valeria
authors: V
authors: Calcaterra
authors: Department of the Mother and Child Health, Pediatric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. savinamannarino@smatteo.pv.it.
authors: Savina
authors: S
authors: Mannarino
authors: Unit of Interventional Radiology, IRCCS Policlinico San Matteo Foundation Pavia, Pavia, Italy. l.moramarco@smatteo.pv.it.
authors: Lorenzo Paolo
authors: LP
authors: Moramarco
authors: Unit of Interventional Radiology, IRCCS Policlinico San Matteo Foundation Pavia, Pavia, Italy. gioleati@gmail.con.
authors: Giovanni
authors: G
authors: Leati
authors: Unit of Interventional Radiology, IRCCS Policlinico San Matteo Foundation Pavia, Pavia, Italy. p.quaretti@smatteo.pv.it.
authors: Pietro
authors: P
authors: Quaretti
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects; D001011:Aorta / Q000187:drug effects; D002220:Carbamazepine / Q000009:adverse effects*; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced / Q000628:therapy*; D006801:Humans; D008297:Male; D009389:Neovascularization, Pathologic / Q000139:chemically induced / Q000628:therapy*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000628:therapy*; D011651:Pulmonary Artery / Q000187:drug effects
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine