Clinical Investigation Of Aortopulmonary Collateral Arteries

Objective:To discuss he clinical manifestaytion and distribution characteristics of aortopulmonary collateral arteries(APCAs)without cyanotic congenital heart defect and to analyze the reason of misdiagnosis.Methods:A retrospective analysis about the patients were diagnosed as APCAs through two dimensional color doppler echocardiography,multidetector-row computed tomography and digital subtraction angiography in the children’s Hospital of Medical University Of Chongqing,between April 2009 to October 2010.The clinical data of 137 APCAs patients without cyanotic congenital heart defect were reviewed.Clinical characteristics,radiographic findings were analyzed.Results:1.In the 137 patients,there were 87 male and 50 female.The average age were 0.15 years old(one hour~ seventeen years old and three month),the finding age were 0.16 years old(four days~ seventeen years old and three month).There were 40 premature and 97 term infants.2.In the 137 patients,99 cases were combined with pulmonary diseases,such as pneumonia,bronchial dysplasia,isolated lung and pulmonary hemosiderosis.115 cases with heart diseases,such as PFO,ASD,VSD and so on.3.In the 137 patients,12 cases were missed by two dimensional color doppler echocardiography,6 cases were misdiagnoses.3 cases were misdiagnoses as PDA.1 case was misdiagnosed as cardiomyopathy.1case was misdiagnosed as pulmonary tuberculosis.1 case prolonged the time of antituberculosis therapy because of the lung lesion.4.There were 130 APCAs(94.9%)originated from descending aorta,5(3.6%)originated from subclavian artery,1(0.73%)originated from intercostals artery,1(0.73%)originated from vertebral artery.5.In the 137 patients,9 patient were occlusion,2 patients were ligated.6.15 APCAs of the 18 followed patient(83.3%)were locked.Conclusion:APCAs exist in the patients without cyanotic congenital heart defect,and APCAs will be narrowed and blocked gradually after birth.Most of the APCAs patients without cyanotic heart defect had no clinical manifestation.Most of the patients were found by Echocardiography due to pulmonary diseases and heart diseases.That kind of APCAs was harmless to human body and could not be treated.Symptomatic APCAs partly with hemoptysis as the first symptom,can easily be diagnosed as pulmonary tuberculosis.Part of the left atrium and left ventricular enlargement were misdiagnosed as cardiomyopathy.Early diagnosis and timely treatment are essential.