Major aortopulmonary collateral arteries (MAPCA's) are persistent tortuous fetal arteries that arise from the descending aorta and supply blood to pulmonary arteries in the lungs usually at the posterior aspect of hilum.
Embryologically, the intersegmental arteries regress with the normal development of pulmonary arteries.
They may persist to supply the pulmonary arteries when there is no flow or very little flow into the pulmonary arteries from the right ventricle. If there is an alternate supply to the pulmonary arteries (e.g. patent ductus arteriosus), then the fetal arteries regress and such patient does not have MAPCAs 1.
They usually arise from the descending aorta. Less commonly, they may arise from ascending aorta or subclavian arteries.
- 1. Rajeshkannan R, Moorthy S, Sreekumar KP et-al. Role of 64-MDCT in evaluation of pulmonary atresia with ventricular septal defect. AJR Am J Roentgenol. 2010;194 (1): 110-8. doi:10.2214/AJR.09.2802 - Pubmed citation
- 2. Murai S, Hamada S, Yamamoto S et-al. Evaluation of major aortopulmonary collateral arteries (MAPCAs) using three-dimensional CT angiography: two case reports. Radiat Med. 2004;22 (3): 186-9. Pubmed citation
- 3. Kinoshita M, Shimizu K, Toda Y et-al. Postoperative coil embolization of residual MAPCAs greatly improved left heart failure in a patient after corrective surgery for pulmonary atresia, ventricular septal defect and MAPCAs. Masui. 2010;59 (11): 1441-5. Pubmed citation
- 4. Murthy K, Reddy KP, Nagarajan R et-al. Management of ventricular septal defect with pulmonary atresia and major aorto pulmonary collateral arteries: Challenges and controversies. Ann Pediatr Cardiol. 2010;3 (2): 127-35. doi:10.4103/0974-2069.74040 - Free text at pubmed - Pubmed citation