Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T14:53:35.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Arterial supply to the lungs in tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis

Published online by Cambridge University Press:  19 August 2008

Siew Yen Ho ,
Gualtiero Catani  and
Jeong-Wook Seo
Siew Yen Ho*
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
Gualtiero Catani
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
Jeong-Wook Seo
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
*
Dr. Slew Yen Ho, Department of Pediatrics, National Heart & Lung Institute, Dovehouse Street London SW3 6LYUnited Kingdom
Get access Rights & Permissions [Opens in a new window]

Summary

The arterial supply to the lungs in cases with tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis is mostly via the arterial duct or else by collateral arteries arising directly or indirectly from the aorta. Nine anatomical specimens with collateral arteries were studied by blunt dissection to determine the arterial supply to each pulmonary segment. The precise supply varied from case to case but, overall, nearly two-thirds of the pulmonary segments were connected to the central pulmonary arteries. A quarter were supplied exclusively by systemic-to-pulmonary collateral arteries, with the remainder having a dual supply. Coexistence of ductal connections and systemic-to-pulmonary collateral arteries was seen in one case. Anastomoses between vessels of different origins were observed up to the segmental level in eight of the nine cases. In four cases, the anastomoses formed arterial rings. The extent of pulmonary parenchyma supplied by arteries from different sources and the presence of arterial anastomoses in these malformations have implications on the planning of surgical repair.

Keywords

Bronchial arteriespulmonary atresiatetralogy of Fallotsystemic-to-pulmonary collateral arteries
Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 1 , January 1992 , pp. 65 - 72
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Jefferson, K, Rees, S, Somerville, J. Systemic arterial supply to the lungs in pulmonary atresia and its relations to pulmonary artery development. Br Heart J 1972; 34: 418–427.CrossRefGoogle Scholar
2.Levin, DC, Baltaxe, HA, Goldberg, HP, Engle, MA, Ebert, PA, Sos, TA, Levin, AR. The importance of selective angiography of systemic arterial supply to the lungs in planning surgical correction of pseudotruncus arteriosus. Am J Roentgenol 1974; 121: 606–612.CrossRefGoogle Scholar
3.Macartney, FJ, Scott, O, Deverall, PB. Hemodynamic and anatomical characteristics of pulmonary blood in pulmonary atresia with ventricular septal defect including a case of persistent fifth arch. Br Heart J 1974; 36: 1049–1060.CrossRefGoogle Scholar
4.McGoon, MD, Fulton, RE, Davis, GD, Ritter, DG, Neill, CA, White, RI Jr. Systemic collateral and pulmonary artery stenosis in patients with congenital valve atresia and ventricular septal defect. Circulation 1977; 56: 473–479.CrossRefGoogle ScholarPubMed
5.Haworth, SG, Macartney, FJ. Growth and development of pulmonary circulation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Br Heart J 1980; 44: 14–24.Google Scholar
6.Rabinovitch, M, Herrera-deLeon, V, Castañeda, AR, Reid, L. Growth and development of the pulmonary vascular bed in patients with tetralogy of Fallot with or without pulmonary atresia. Circulation 1981; 64: 1234–1249.CrossRefGoogle ScholarPubMed
7.Liao, PK, Edwards, WD, Julsrud, PR, Puja, FJ, Danielson, GK, Feldt, RH. Pulmonary blood supply in patients with pulmonary atresia and ventricular septal defect. J Am Coll Cardiol 1985; 6: 1343–1350.CrossRefGoogle ScholarPubMed
8.Anderson, RH, Devine, WA, del, Nido P. The surgical anatomy of tetralogy of Fallot with pulmonary atresia rather than pulmonary stenosis. J Card Surg 1991; 6: 41–58.Google Scholar
9.Tynan, MJ, Gleeson, JA. Pulmonary atresia with bronchial arteries arising from the subclavian arteries. Br Heart J 1966; 28: 573–576.CrossRefGoogle ScholarPubMed
10.Rossi, M, Rossi, Filho R, Ho, SY. Solitary arterial trunk with pulmonary atresia and arteries with supply to the left lung from both an arterial duct and systemic-pulmonary collateral arteries. Int J Cardiol 1988; 20: 145–148.CrossRefGoogle Scholar
11.Krongrad, E, Ritter, DG, Hawe, A, Kincaid, OW, McGoon, DC. Pulmonary atresia or severe stenosis and coronary artery -pulmonary artery fistula. Circulation 1972; 46: 1005–1012.CrossRefGoogle ScholarPubMed
12.Iyer, KS, Mee, RBB. Staged repair of pulmonary atresia with ventricular septal defect and major systemic to pulmonary collateral arteries. Ann Thorac Surg 1991; 51: 65–72.CrossRefGoogle Scholar
13.Puga, F. Unifocalization for pulmonary atresia with ventricular septal defect. Ann Thorac Surg 1991; 51: 8–9. [Editorial]CrossRefGoogle ScholarPubMed
14.Stark, J. Editorial comment. J Card Surg 1991; 6: 58–59.CrossRefGoogle Scholar
15.Shimazaki, Y, lio, M, Nakano, S, Morimoto, S, Ikawa, S, Matsuda, H, Kawashima, Y. Pulmonary artery morphology and hemo-dynamics in pulmonic valve atresia with ventricular septal defect before and after repair. Am J Cardiol 1991; 67: 744–748.Google Scholar
16.McGoon, DC, Baird, DK, Davies, GD. Surgical management of large bronchial collateral arteries with pulmonary stenosis or atresia. Circulation 1975; 52: 109–118.CrossRefGoogle ScholarPubMed
17.Thiene, G, Anderson, RH. Pulmonary atresia with ventricular septal defect: Anatomy. In: Anderson, RH, Macartney, FJ, Shinebourne, EA, Tynan, M (eds). Paediatric Cardiology Volume 5. Churchill Livingstone, Edinburgh, 1983, pp 80–101.Google Scholar
18.Thiene, G, Frescura, C, Bini, RM, Valente, ML, Gallucci, V. Histology of pulmonary atresia with ventricular septal defect. Circulation 1979; 60: 1066–1074.CrossRefGoogle ScholarPubMed
19.Faller, K, Haworth, SG, Taylor, JFN, Macartney, FJ. Duplicate sources of blood supply in pulmonary atresia with ventricular septal defect. Br Heart J 1981; 46: 263–268.CrossRefGoogle ScholarPubMed
20.Thiene, G, Frescura, C, Bortolotti, U, Del Maschio, A, Valente, ML. The systemic pulmonary circulation in pulmonary atresia with ventricular septal defect: concept of reciprocal development of the fourth and sixth aortic arches. Am Heart J 1981; 101: 339–344.CrossRefGoogle ScholarPubMed
21.Frescura, C, Talenti, E, Pelligrino, PA, Mazzucco, A, Faggian, G, Thiene, G. Coexistence of ductal and systemic pulmonary arterial supply in pulmonary atresia with ventricular septal defect. Am J Cardiol 1984; 53: 348–349.CrossRefGoogle ScholarPubMed
22.Haworth, SG. Collateral arteries in pulmonary atresia with ventricular septal defect. A precarious blood supply. Br Heart J 1980; 44: 5–13.CrossRefGoogle ScholarPubMed
23.Haworth, SG, Rees, PG, Taylor, JFN, Macartney, FJ, de Leval, M, Stark, J. Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Effect of systemic pulmonary anastomosis. Br Heart J 1981;45: 133–141.CrossRefGoogle ScholarPubMed