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  • 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].
    Author: Kinoshita M, Shimizu K, Toda Y, Suzuki S, Suemori T, Iwasaki T, Takahashi T, Morita K.
    Journal: Masui; 2010 Nov; 59(11):1441-5. PubMed ID: 21077320.
    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.
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