Major Aortopulmonary Collateral Arteries Program
Treatments and Services

Expert Imaging Techniques, Medical Therapies and Surgical Procedures

We combine access to advanced imaging techniques with innovative medical and surgical interventions to create personalized treatment recommendations for your child’s complex needs.

Most infants with major aortopulmonary collateral arteries (MAPCAs) have underdeveloped pulmonary arteries. We promote the growth of native pulmonary arteries. This improves the future success of surgical repair and unifocalization—combining the abnormal MAPCAs with the existing pulmonary artery to form a functioning vessel.

Treatment Approach for MAPCAs

We use our deep experience and expertise to evaluate your child’s condition with the most advanced imaging tools available. We create a 3D map of the heart anatomy.

A team of specialists—including cardiologists, pulmonologists, radiologists and surgeons—reviews every patient case. They discuss the best interventional and surgical options and the need for additional specialists. This intense team-based review gives your child the highest level of care.

Superior Imaging and Diagnostic Evaluation

We spot most cases of MAPCAs on ultrasound during pregnancy. When you come to Cincinnati Children’s for your baby’s care, we complete a comprehensive diagnostic evaluation that may include:

  • 2D echocardiography. This noninvasive test uses sound waves to share moving, real-time images of heart structures in action.
  • Cardiac CT with 3D reconstructions. Data from a computed tomography scan creates a visual model of the heart anatomy.
  • Cardiac catheterization. An interventional cardiologist inserts a thin tube with a tiny camera through a blood vessel in the groin or arm and guides it to the heart. This shows images of the heart structures, vessels and any blockages.
  • Virtual reality imaging. VR tools build an interactive, 3D model of the heart using your child’s imaging data from other diagnostic tests.

Our advanced imaging techniques clearly define the anatomical details of the major aortopulmonary collaterals and any existing heart anomalies.

Building the Treatment Plan

Our care team develops an individualized treatment strategy for your child using their imaging data.

We use 3D and virtual reality models to predict procedure outcomes. These tools help design the right cardiac catheterization interventions and the best surgical approach.

Treatments to Grow the Pulmonary Arteries

Your child’s initial treatment will come in early infancy. We use an advanced, minimally invasive trans-catheter technique to encourage growth of the central pulmonary arteries.

We strive to avoid or delay surgery.

When catheter-based options are not the best for your child, we perform an early surgical intervention. This procedure typically creates a right ventricle-to-pulmonary artery connection or central shunt to promote pulmonary artery growth.

Coordinated, Ongoing Surveillance and Care

In most children, the pulmonary arteries achieve needed growth within a few months.

Your child can be at home during this time, but we provide frequent outpatient monitoring to check:

  • Cardiovascular performance
  • Growth of pulmonary arteries
  • Overall growth and development

Sometimes, we perform cardiac catheterization to assess blood flow dynamics. If too much or too little blood is entering the lungs, your child may need an advanced catheter procedure. These techniques include:

  • MAPCAs coiling
  • Occlusion of non-contributing vessels
  • Placement of pulmonary flow restrictors

These procedures regulate blood flow and help optimize pulmonary artery growth.

Treatments for Pulmonary Artery Reconstruction

By 8 to 12 months, your child will be ready for surgery. Whenever possible, we perform a complete repair of the heart anomaly and reconstruction of the pulmonary arteries and MAPCAs during the same procedure.

Known as unifocalization, the reconstruction surgery rebuilds the connection between the heart and lungs. The surgery combines the existing pulmonary artery and the MAPCAs into a single blood vessel. Then, we attach it to the right ventricle.

We regularly monitor your child after surgery. Many children need follow-up cardiac catheterization procedures throughout their lifetime. These enhance or maintain pulmonary artery growth.

Second Opinions for MAPCAs

As a Midwest referral center, we provide consultations to families seeking care for their children with MAPCAs. A second opinion from one of our specialists can help you make informed decisions about your child’s care.