Staged Repair of Tetralogy of Fallot, Pulmonary Atresia, and MAPCAs
(A) Pre-operative anatomy. (B) Unifocalization of right-sided major aortopulmonary collateral arteries (MAPCAs) and small right pulmonary artery (PA)–to–right modified Blalock-Taussig-Thomas shunt. (C) Use of 3D model in the operating room for procedural guidance. (D) Unifocalization of left-sided major aortopulmonary collateral arteries–to–left modified Blalock-Taussig-Thomas shunt. (E) Right ventricular (RV)–to–pulmonary artery conduit placement (green) to unifocalized major aortopulmonary collateral arteries and takedown of bilateral modified Blalock-Taussig-Thomas shunts. APC = aortopulmonary collateral; LSCA = left subclavian artery; PTFE = polytetrafluoroethylene; SVC = superior vena cava.