The association of pulmonary atresia, ventricular septal Tactile Switches defect (VSD) and major aortopulmonary collaterals (MAPCA) is an extreme form of tetralogy of Fallot (TOF).It carries a high mortality risk if not intervened on during infancy with only 20% of unoperated patients surviving into adulthood.We present the case of a 40-year-old man who presented for evaluation prior to retinal surgery and was found to have hypoxia and a loud murmur.Cardiac catheterization was performed in the general catheterization laboratory, demonstrating a membranous VSD, pulmonary atresia, and MAPCA.
We highlight the challenges and limitations that an adult interventional BOSCH Serie 4 KGN39VL35G 60/40 Fridge Freezer - Silver cardiologist may have when encountering these patients.