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1.consequence ICR with out simaltaneous  MAPCA ligation?

if MAPCA persists after ICR then there is free flow of  blood to lungs and patient develops pulmonary oedema although 1st  and 2 nd POD  might be uneventful.

there will be fall of SaO2 and its mistaken or overseen as usual finding of a TOF case but close eye should be kept in respiratory rate which will be heigh if there is any other real pathology,

eventually patient will develop respiratory dystress.

Chest Xray will show bilateral/unilateral massive  pleural effusion.and chest drain is routinely advised in the hope to drain fluid and its another mistake if fluid is not examined.

fluid should be sent for study and if its proven transudative then assume that its a reactive effusion due to pulmonary oedema

and aggressive treatment for correction of oedema is the call with very  less hope of recovery.and eventually patient will die

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