Case report of transcatheter flow restriction in isolated non-redundant major aorto-pulmonary collateral arteries.

Background: Major aorto-pulmonary collateral arteries 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 haemoptysis, 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 haemoptysis 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 centred shared decision-making were utilized while discussing this case.