Case report of Transcatheter Flow Restriction in Isolated Non-Redundant Major Aortopulmonary Collateral Arteries

Background Major aorto-pulmonary collateral arteries (MAPCA) are congenital remnants of the segmental arteries that supply the lungs. They are commonly associated with congenital heart disease, particularly in cases where the main pulmonary artery branches are not well developed, these segmental collaterals do not regress and continue to supply oxygenated blood to the pulmonary vasculature. Over time, these collaterals can become problematic, particularly if they enlarge, leading to clinically significant symptoms such as hemoptysis, segmental pulmonary hypertension, and left heart volume overload. Case summary Herein, we describe a rare case of isolated major aorto-pulmonary collaterals without associated congenital heart disease that presented with hemoptysis and managed percutaneously with a modified flow-reducer device. Discussion This is a novel therapy for this very unique clinical scenario. Both multidisciplinary discussion and patient centered shared decision making were utilized while discussing this case.