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Systemic-to-pulmonary blood supply in tetralogy of Fallot with pulmonary atresia

Published online by Cambridge University Press:  30 July 2009

Renata N. Rossi ,
Alison Hislop ,
Robert H. Anderson ,
F. Maymone Martins  and
Andrew C. Cook
Renata N. Rossi
Affiliation:
Paediatric Cardiac Unit, Hospital de Santa Cruz, Lisbon, Portugal
Alison Hislop
Affiliation:
Vascular Biology Unit, Institute of Child Health, London, UK
Robert H. Anderson
Affiliation:
Cardiac Unit, Institute of Child Health, London, UK
F. Maymone Martins
Affiliation:
Paediatric Cardiac Unit, Hospital de Santa Cruz, Lisbon, Portugal
Andrew C. Cook*
Affiliation:
Cardiac Unit, Institute of Child Health, London, UK
*
Cardiac Unic, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. Tel: +44 207 905 2343; Fax: +44 207 905 2324; E-mail: a.cook@ich.ucl.ac.uk
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Abstract

Tetralogy of Fallot with pulmonary atresia is one of the most challenging congenital cardiac malformations, for the morphologist, cardiologist and surgeon alike. Much of the difficulty in this lesion concerns the nature and development of pulmonary arterial supply, and the manner in which complete segmental supply to the lungs can be successfully restored or maintained. In this review, we discuss the anatomy and nomenclature of the lesion, emphasising the variability that can occur in pulmonary arterial anatomy, particularly in the presence of systemic-to-pulmonary collateral arteries. We speculate on the likely embryologic origins of these connections. Then by means of anatomic-clinical correlations, we emphasise the diagnostic approach to delineating the origin and extent of the pulmonary vasculature.

Keywords

Pulmonary atresia with ventricular septal defectdevelopmentbronchial arteriesangiography
Type
Continuing Medical Education
Information
Cardiology in the Young , Volume 12 , Issue 4 , July 2002 , pp. 373 - 388
Copyright
Copyright © Cambridge University Press 2002

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