Tetralogy of Fallot with major aortopulmonary collateral arteries is a complex and
heterogenous condition varying degrees of severity, while MAPCA present in 20-25%
with TOF and pulmonary atresia. Our institutional approach to this lesion emphasizes
presurgical endovascular multiple coil embolization ofsignificant bilateral MAPCAs
along with complete intracardiac repair in the same sitting. The presurgical endovascular
coil embolization of all MAPCAs of more than 3mm and complete intracardiac repairwere
done in the same sitting. The multiple Boston scientific pushable cols of diameters
ranging. The presence of MAPCAs is a major determining factor in the prognosis and
management of TOF The role of the cardiac radiologist is not only in reporting critical
components regarding collateral arteries and underlying cardiac structural disease but
also in the management of TOF with MAPCAs along with cardiac surgeons.