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In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.Humans have pre-formed collateral vessels that enlarge with ischemia. In addition, new vessels can be formed within ischemic zones from pre-formed endocardial arcades of vessels providing rich collateral flow. Collateral flow under resting conditions (if 25% of normal) is enough to maintain myocardial viability, but may be insufficient to prevent myocardial i