Major Aorto Pulmonary Collaterals (MAPCAs)

What do you mean by MAPCAs? 

These abnormal arteries are nature’s response to low flow to the lungs and the lack of oxygen in the body that follows. 

Examples of such conditions  are Tetralogy of Fallot, Pulmonary atresia, Single ventricle pulmonary stenosis or atresia situations, or any condition where the pulmonary blood flow is inadequate.

 

Difficulties faced: 

During heart surgery collaterals or MAPCAs may make the repair difficult for the surgeons. They can result in unnecessary bleeding or reduce the effectiveness of the heart lung machine. They can also cause bleeding into the lungs in the postoperative period and can contribute to high pressures in the lung arteries.   

 

Complications: 

Complications are rare in experienced hands and include:

  1. Dislodgement of the coils. These are easily retrieved in the cath lab itself.

  2. Injury to the vessels and occlusion (blockage) of normal vessels.