Transcatheter Closure of Aortopulmonary Window in Infants with Amplatzer Duct Occluder-I

Abstract

Aortopulmonary window (APW) is a septation defect between the ascending aorta and main pulmonary artery, and it accounts for 0.2-0.6% of all congenital heart diseases. The diagnosis is made by detecting the defect between the ascending aorta and pulmonary artery while both semilunar valves are fully developed. Based on the anatomical characteristics, APW is classified into four types: proximal (Type 1) defect, distal (Type 2) defect, total (Type 3) defect and intermediate (Type 4) defect. APW is traditionally treated by surgery, and there are a few reports about transcatheter APW closure in infancy. Only defects with adequate superior and inferior rims can be considered for device closure. We describe two cases who underwent transcatheter APW closure with the Amplatzer duct occluder-I (ADO-I). Our experience shows that the ADO-I can achieve good results in closure of APW for selected patients.

Keywords: Amplatzer duct occluder-I; Aortopulmonary window; Infant.

Figure 1

(A) Echocardiographic examination demonstrated a 3.5-4 mm wide defect between the ascending aorta and the main pulmonary artery (white arrow). (B) Color Doppler shows defect between the ascending aorta and the main pulmonary artery (white arrow). (C) Computed tomography revealed a tubular shaped APW with well-formed inferior and superior rims (white arrow). (D) Angiography shows a 4.1 mm APW at the narrowest point with a 7 mm longutidinal length. (E) Control angiogram was performed before the device was completely released. (F) Angiogram after the device was completely released. Ao, aorta; APW, aortopulmonary window; PA, pulmonary artery.