{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:00:16Z","timestamp":1787497216523,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Due in part to the heterogeneity of the pulmonary circulation in patients with tetralogy of Fallot and major aortopulmonary collateral arteries (MAPCAs), research on this condition has focused on relatively basic anatomic characteristics. We aimed to detail pulmonary artery (PA) and MAPCA anatomy in a large group of infants, assess relationships between anatomy and early surgical outcomes, and consider systems for classifying MAPCAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">All infants ( &lt;1\u00a0year of age) undergoing first cardiac surgery for tetralogy of Fallot\/MAPCAs from 2001 to 2019 at Stanford University were identified. Preoperative angiograms delineating supply to all 18 pulmonary segments were reviewed for details of each MAPCA and the arborization and size of central PAs. We studied 276 patients with 1068 MAPCAs and the following PA patterns: 152 (55%) incompletely arborizing PAs, 48 (17%) normally arborizing PAs, 45 (16%) absent PAs, and 31 (11%) unilateral MAPCAs. There was extensive anatomic variability, but no difference in early outcomes according to PA arborization or the predominance of PAs or MAPCAs. Patients with low total MAPCA and\/or PA cross\u2010sectional area were less likely to undergo complete repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">MAPCA anatomy is highly variable and essentially unique for each patient. Though each pulmonary segment can be supplied by a MAPCA, central PA, or both, all anatomic combinations are similarly conducive to a good repair. Total cross\u2010sectional area of central PA and MAPCA material is an important driver of outcome. We elucidate a number of novel associations between anatomic features, but the extreme variability of the pulmonary circulation makes a granular tetralogy of Fallot\/MAPCA classification system unrealistic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017981","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T05:04:10Z","timestamp":1607144650000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Angiographic Anatomy of Major Aortopulmonary Collateral Arteries and Association With Early Surgical Outcomes in Tetralogy of Fallot"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4313-0983","authenticated-orcid":false,"given":"Gregory T.","family":"Adamson","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doff B.","family":"McElhinney","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"},{"name":"Division of Pediatric Cardiac Surgery Department of Cardiothoracic Surgery Stanford University School of Medicine Palo Alto CA"},{"name":"Clinical and Translational Research Program Lucile Packard Children's Hospital Heart CenterStanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Program Lucile Packard Children's Hospital Heart CenterStanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6078-5976","authenticated-orcid":false,"given":"Jeffrey A.","family":"Feinstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn F.","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery Department of Cardiothoracic Surgery Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A.","family":"Algaze","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank L.","family":"Hanley","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery Department of Cardiothoracic Surgery Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanton B.","family":"Perry","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"653","volume-title":"Anderson's Paediatric Cardiology","author":"Asija R","year":"2019","unstructured":"Asija R, Ma M, Wise\u2010Faberowski L, Presnell L, Anderson RH, McElhinney DB, Hanley FL. Tetralogy of Fallot with pulmonary atresia. In: Wernovsky G, Anderson RH, Kumar KJ, Mussato K, Redington AN, Tweddell JS, eds. Anderson's Paediatric Cardiology. 4th ed. 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