Original articleCongenital heart surgeryPrevalence and Anatomy of Retroesophageal Major Aortopulmonary Collateral Arteries
Section snippets
Material and Methods
The Stanford University Institutional Review Board approved this study. Patients eligible for inclusion in the study were those undergoing a primary surgical procedure for PA/VSD/MAPCAs. The study summarizes our experience with 68 consecutive patients undergoing PA/VSD/MAPCA operations from March 2013 through October 2015.
We perform the entire MAPCA dissection before cardiopulmonary bypass is initiated. This dissection is performed between the ascending aorta and superior vena cava and inferior
Results
A retroesophageal MAPCA was diagnosed in 45 of the 68 patients (67%) intraoperatively. However, the prevalence of retroesophageal MAPCAs differed significantly depending on whether there was a left or right aortic arch (Fig 4). The prevalence of retroesophageal MAPCAs was 77% for the 36 patients who had a left aortic arch vs 53% in the 32 patients who had a right aortic arch (p < 0.05).
Of the 45 patients with retroesophageal MAPCAs, 41 (91%) had 1 retroesophageal MAPCA, and 4 had 2
Comment
This study was performed to evaluate the prevalence and anatomy of retroesophageal MAPCAs in patients with PA/VSD/MAPCAs. These data demonstrate that a retroesophageal MAPCA was identified during the operation in 45 of 68 patients (67%). Of the 45 patients with a retroesophageal MAPCA, 41 had 1 retroesophageal MAPCA, and 3 had 2 retroesophageal MAPCAs. Thus, 49 retroesophageal MAPCAs were identified during the operation, of which 23 were intraesophageal. A significant difference was noted in
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Midterm fate of unifocalized major aortopulmonary collateral arteries in patients with retroesophageal major aortopulmonary collateral arteries
2022, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The 37 patients included in this study were a highly select cohort based on the requirement to have at least 1 retroesophageal MAPCA. This subset of patients has been intensely scrutinized with detailed mapping of their MAPCA and pulmonary artery anatomy.12,13 The majority of these patients have now been followed for an extensive period of time (median, 69 months), with comprehensive follow-up obtained, including the cardiac catheterization and surgical history.
To Unifocalize or Not to Unifocalize?: A Comparison of Retroesophageal Versus Anterior Collaterals
2022, Annals of Thoracic SurgeryCitation Excerpt :While most MAPCAs are located anteriorly, there is a smaller subset of MAPCAs that course behind the esophagus (REMs). We previously evaluated the prevalence and anatomy of REMs in a paper published several years ago.12 The current study sought to evaluate the physiologic and surgical implications of REMs vs anteriorly located MAPCAs.
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2018, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The most common origin of MAPCAs is off the anterior surface of the descending aorta. However, two thirds of patients will have a retro-esophageal MAPCA, which originates from the lateral side of the aorta.30 Retro-esophageal MAPCAs are frequently posterior to the airway and have midsegment stenoses, and therefore require a different surgical approach compared with MAPCAs originating from the anterior aorta.
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