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Perfusion. 2014 Nov;29(6):567-70. doi: 10.1177/0267659114540019. Epub 2014 Jun 19.

Tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral vessels.

Author information

1
Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK Institute of Cardiovascular Science, University College London, UK richard.issitt@gosh.nhs.uk.
2
Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
3
Institute of Cardiovascular Science, University College London, UK Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK.

Abstract

Major aortopulmonary collateral arteries (MAPCAs) provide significant issues during cardiopulmonary bypass, including flooding of the surgical field which requires significant blood volumes to be returned to the extracorporeal circuit via handheld suckers. This has been shown to be the major source of gaseous microemboli and is associated with adverse neurological outcome. Use of pH-stat has been previously shown to decrease the shunt through MAPCAs via an unknown mechanism. Here, we report the associated benefits of pH-stat in decreasing sucker usage and gaseous microemboli in a patient with known MAPCAs presenting for repair of tetralogy of Fallot and pulmonary atresia.

KEYWORDS:

CHD; CPB; cardiac anatomy/pathologic anatomy; collateral blood flow (lungs); embolism (gaseous); physiology/pathophysiology; tetralogy of Fallot

PMID:
24947458
DOI:
10.1177/0267659114540019
[Indexed for MEDLINE]
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