Two-dimensional echocardiographic recognition and surgical management of aortopulmonary septal defect in the premature infant.
An aorticopulmonary septal defect (APSD) results from failure of proper conotruncal separation. The hemodynamic consequences of this lesion closely resemble that of other large left-to-right shunt defects, especially a patent ductus arteriosus (PDA). Failure to differentiate these 2 abnormalities has not infrequently led to an inappropriate surgical approach in pursuit of the far more common PDA. This report describes the two-dimensional echocardiographic (2-DE) recognition of an APSD in 2 premature infants. Survival of these delicate neonates indicates that successful surgery can be performed even in small infants. A thorough 2-DE examination for an APSD is recommended for any infant before proceeding to surgery for a suspected PDA, especially when cardiac catheterization has not been performed.
D001011:Aorta / Q000002:abnormalities*; D006348:Cardiac Surgical Procedures / Q000379:methods; D003937:Diagnosis, Differential; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis; D006343:Heart Septal Defects / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D011651:Pulmonary Artery / Q000002:abnormalities*