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. 2018 Jan 9;26(1):30-37.
doi: 10.5606/tgkdc.dergisi.2018.14772. eCollection 2018 Jan.

Diagnosis and surgical treatment of aortopulmonary window: Our single-center experience

Kahraman Yakut  1 , N Kürşad Tokel  1 , Murat Özkan  2 , Birgül Varan  1 , İlkay Erdoğan  1 , Sait Aşlamacı  2
Affiliations

Diagnosis and surgical treatment of aortopulmonary window: Our single-center experience

Kahraman Yakut et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

Background: In this study, we aimed to report our single-center experience in aortopulmonary window and review clinical signs, symptoms, surgical correction techniques, and long-term outcomes.

Methods: We retrospectively reviewed the medical records of a total of 30 patients who were followed with the diagnosis of aortopulmonary window in our hospital between May 1998 and June 2016. The clinical characteristics of the patients, echocardiographic and angiographic findings, surgical treatment outcomes, and medical problems during follow-up were reviewed.

Results: The most common signs and symptoms were murmur, dyspnea, tachypnea, growth retardation, and signs of congestive heart failure. The mean age at the time of surgery was 8.2±14.4 months (7 days to 60 months). Eighteen patients (60%) had additional congenital cardiac anomalies. Eleven patients had simple congenital heart diseases, and seven patients had complex congenital heart diseases. Four patients were unable to be operated due to Eisenmenger syndrome (n=3) and complex congenital heart disease (n=1). No early or late postoperative death was observed. The mean follow-up was 6.4±4.8 years (range, 5 months to 16 years). In addition to aortopulmonary window repair, an additional cardiac anomaly modifying surgical intervention was corrected in nine patients (34.6%). One patient was reoperated for residual aortopulmonary window and another patient for pulmonary stenosis (valvular, supravalvar) after three years. One of these patients underwent pulmonary balloon valvuloplasty after two years. The reoperation rate was 7.7% (n=2) during follow-up.

Conclusion: Aortopulmonary window is a rare cardiac anomaly which may be overlooked by echocardiographic study, and which is amenable for repair with low-surgical risk. It is, therefore, imperative to diagnose and treat this condition, before pulmonary vascular disease develops.

Keywords: Aortopulmonary window; congenital heart disease; pulmonary vascular disease; surgical treatment.

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Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. Aortopulmonary window is seen on computed tomography angiography. Ao: Aorta; APW: Aortopulmonary window; MPA: Main pulmonary artery; LPA: Left pulmonary artery; RPA: Right pulmonary artery.
Figure 2
Figure 2. Catheter angiography shows that the catheter passes from the main pulmonary artery to the ascending aorta through the aortopulmonary window. Angiography performed ascending aorta shows that the contrast passes from the aorta to the pulmonary artery through the aortopulmonary window. Ao: Aorta; APW: Aortopulmonary window; MPA: Main pulmonary artery; LPA: Left pulmonary artery; RPA: Right pulmonary artery.
Figure 3
Figure 3. Aortopulmonary window showing in parasternal short axis image on transthoracic echocardiographic examination. Ao: Aorta; APW: Aortopulmonary window; MPA: Main Pulmonary artery; RVOT: Right ventricular outflow tract; PA: Pulmonary annulus.
Figure 4
Figure 4. Aortopulmonary window is seen during surgery. APW: Aortopulmonary window; MPA: Main Pulmonary artery.
See this image and copyright information in PMC

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