Journal of Pediatric Cardiology and Cardiac Surgery

Major aortopulmonary collateral artery (MAPCA) with diminutive pulmonary artery (PA) is a complex and rare form of congenital heart disease. The most important consideration in this disease is how to facilitate pulmonary arterial growth. Generally, a surgical strategy involving unifocalization of the MAPCAs or rehabilitation of the native PA is used. We report two rare cases of complete transcatheter rehabilitation of the native PA without surgery in patients with MAPCAs and diminutive pulmonary antegrade flow, using balloon valvuoplasty and embolization. The important factors in this strategy were a sufficient dual supply from the native PA and the MAPCAs, as well as a subarterial ventricular septal defect. This strategy can be a useful option as a bridge to definitive repair for this particular patient group, and therefore palliative surgery in early infancy, which is associated with a relatively high mortality, can be avoided.