HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): A. J. J. C. Bogers Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DeRuiter, M. C. Articles by Elzenga, N. J. Search for Related Content PubMed PubMed Citation Articles by DeRuiter, M. C. Articles by Elzenga, N. J.

J Thorac Cardiovasc Surg 1994;108:692-699
© 1994 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

The restricted surgical relevance of morphologic criteria to classify systemic-pulmonary collateral arteries in pulmonary atresia with ventricular septal defect

Leiden

A. J. J. C. Bogers, MD, PhD

Rotterdam

N. J. Elzenga, MD, PhD

Groningen, The Netherlands

Supported by the Netherlands Heart Foundation (grant 87062).

Received for publication March 2, 1994. Accepted for publication May 23, 1994. Address for reprints: M. C. DeRuiter, PhD, Department of Anatomy and Embryology, University of Leiden, P.O. Box 9602, 2300 RC Leiden, The Netherlands.

Abstract

Now that systemic-pulmonary collateral arteries are used for unifocalization in patients with pulmonary atresia and ventricular septal defect, the question arises whether morphologic criteria of these collateral arteries could help to provide better results. In an attempt to classify the morphologic features of systemic-pulmonary collateral arteries, we studied 31 heart-lung autopsy specimens with pulmonary atresia and ventricular septal defect. The course of the systemic-pulmonary collateral arteries (origin, branching pattern, and conections with systemic and central pulmonary arteries) was related to their histologic characteristics. The results show that systemic-pulmonary collateral arteries cannot be classified according to their course related to the trachea and the main branches of the bronchi. The histologic features of these collateral arteries vary along their course to the lungs. Nearly all systemic-pulmonary collateral arteries contain a muscular or a musculoelastic segment. One type of collateral artery (complex loop anastomoses) is completelymuscular and resembles a bronchial artery. Nutritive branches (bronchial arteries) arise from all histologic types of systemic-pulmonary collateral artery segments. The size and number of intimal proliferations in muscular, elastic, and musculoelastic segments did not differ significantly. In 29 of 31 cases a ductus arteriosus did not coexist with large collateral arteries (two cases unknown). It is concluded that a classification of large systemic-pulmonary collateral arteries based on morphologic features results in a highly variable system, which does not facilitate decisions for the suitability of these arteries for unifocalization procedures. The variability of the systemic-pulmonary collateral arteries corresponds with the recent embryologic finding that during development, collateral artery formation is possible during extended periods. (J THORAC CARDIOVASC SURG 1994;108:692-9)

This article has been cited by other articles:

				M Chessa, G Butera, P Bonhoeffer, L Iserin, J Kachaner, S Lyonnet, A Munnich, D Sidi, and D Bonnet Relation of genotype 22q11 deletion to phenotype of pulmonary vessels in tetralogy of Fallot and pulmonary atresia-ventricular septal defect Heart, February 1, 1998; 79(2): 186 - 190. [Abstract] [Full Text]

				F. D. Pagani, J. P. Cheatham, R. H. Beekman III, T. R. Lloyd, R. S. Mosca, and E. L. Bove THE MANAGEMENT OF TETRALOGY OF FALLOT WITH PULMONARY ATRESIA AND DIMINUTIVE PULMONARY ARTERIES J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1521 - 1533. [Abstract] [Full Text]