{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:04:43Z","timestamp":1782331483524,"version":"3.54.5"},"reference-count":26,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals is a complex congenital heart defect that includes a heterogeneous subgroup of patients. Variation in the sources of pulmonary blood flow contributes to the complexity of the lesion and the diversity of approaches to its management. Unifocalization and rehabilitation focus on mobilization of collateral arteries and growth of native pulmonary arteries, respectively, with the ultimate surgical goal of achieving separated systemic and pulmonary circulations with the lowest possible right ventricular pressure. Regardless of the strategy, outcomes have altered the natural history of the disease, with a complete repair rate of approximately 80% and low early and late mortality rates. Given this heterogeneity of pulmonary vasculature, a tailored approach should be adopted for each patient, using all diagnostic methods currently offered by technical developments.<\/jats:p>","DOI":"10.3390\/children9040515","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T11:26:07Z","timestamp":1649157967000},"page":"515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Modern Surgical Approach to Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collateral Arteries"],"prefix":"10.3390","volume":"9","author":[{"given":"Matteo","family":"Trezzi","sequence":"first","affiliation":[{"name":"Units of Cardiac Surgery, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Cetrano","sequence":"additional","affiliation":[{"name":"Units of Cardiac Surgery, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia B.","family":"Albanese","sequence":"additional","affiliation":[{"name":"Units of Cardiac Surgery, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Borro","sequence":"additional","affiliation":[{"name":"Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2611-8061","authenticated-orcid":false,"given":"Aurelio","family":"Secinaro","sequence":"additional","affiliation":[{"name":"Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-5091","authenticated-orcid":false,"given":"Adriano","family":"Carotti","sequence":"additional","affiliation":[{"name":"Units of Cardiac Surgery, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/hrt.34.4.418","article-title":"Systemic arterial supply to the lungs in pulmonary atresia and its relation to pulmonary artery development","volume":"34","author":"Jefferson","year":"1972","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1161\/01.CIR.64.6.1234","article-title":"Growth and development of the pulmonary vascular bed in patients with tetralogy of Fallot with or without pulmonary atresia","volume":"64","author":"Rabinovitch","year":"1981","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jcmg.2014.04.030","article-title":"A Novel Approach to Neonatal Management of Tetralogy of Fallot, With Pulmonary Atresia, and Multiple Aortopulmonary Collaterals","volume":"8","author":"Ryan","year":"2015","journal-title":"JACC Cardiovasc. 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