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Arterial supply to the lungs in tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis

Published online by Cambridge University Press:  19 August 2008

Siew Yen Ho*
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
Gualtiero Catani
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
Jeong-Wook Seo
Affiliation:
Department of Paediatrics, National Heart & Lung Institute, London
*
Dr. Slew Yen Ho, Department of Pediatrics, National Heart & Lung Institute, Dovehouse Street London SW3 6LYUnited Kingdom

Summary

The arterial supply to the lungs in cases with tetralogy of Fallot with pulmonary atresia or critical pulmonary stenosis is mostly via the arterial duct or else by collateral arteries arising directly or indirectly from the aorta. Nine anatomical specimens with collateral arteries were studied by blunt dissection to determine the arterial supply to each pulmonary segment. The precise supply varied from case to case but, overall, nearly two-thirds of the pulmonary segments were connected to the central pulmonary arteries. A quarter were supplied exclusively by systemic-to-pulmonary collateral arteries, with the remainder having a dual supply. Coexistence of ductal connections and systemic-to-pulmonary collateral arteries was seen in one case. Anastomoses between vessels of different origins were observed up to the segmental level in eight of the nine cases. In four cases, the anastomoses formed arterial rings. The extent of pulmonary parenchyma supplied by arteries from different sources and the presence of arterial anastomoses in these malformations have implications on the planning of surgical repair.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

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