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Pulmonary Hemorrhage After Arterial Switch Operation.

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Major aortopulmonary collateral arteries, rare in neonates, can cause pulmonary hemorrhage after arterial switch operations. Coil embolization successfully treated this complication, ensuring a positive outcome.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Major aortopulmonary collateral arteries (MAPCAs) are known to complicate the postoperative course following arterial switch operations (ASO).
  • Heart failure is the typical clinical presentation associated with MAPCAs in this context.
  • This case highlights a rare, yet significant, postoperative complication.

Observation:

  • A neonate with transposition of the great arteries, intact interventricular septum, and situs inversus totalis underwent an uneventful ASO.
  • The patient developed persistent postoperative pulmonary hemorrhage, a rare presentation.
  • The hemorrhage was attributed to an undiagnosed MAPCA.

Findings:

  • The identified MAPCA was successfully treated using coil embolization.
  • This interventional approach resolved the pulmonary hemorrhage.
  • The neonate experienced a favorable outcome post-embolization.

Implications:

  • This case underscores the importance of considering MAPCAs even after seemingly uncomplicated ASO.
  • Persistent pulmonary hemorrhage in neonates post-ASO warrants thorough investigation for MAPCAs.
  • Coil embolization presents a viable and effective treatment option for MAPCA-induced pulmonary hemorrhage.