Diagnosis, management, and results of treatment for aortopulmonary window.
The aortopulmonary window is a communication between the ascending aorta and the pulmonary trunk in the presence of two separate arterial valves. This uncommon congenital anomaly is reported rarely in the literature. We present here our experience with 16 patients, emphasizing the importance of early closure of the defect by a transaortic approach. We performed surgery on 16 patients over a period of 13 years using a transaortic approach under cardiopulmonary bypass. The median age of the patients at the time of operation was 6.5 months, with a range from 1 month to 11 years. Preoperative pulmonary arterial systolic pressure ranged from 30 to 100 mmHg. Associated cardiac anomalies were present in 7 of the patients, and were repaired at the same stage. The defect was between the ascending aorta and the proximal pulmonary trunk in 13 patients, and between the ascending aorta and the distal pulmonary trunk, with overriding of the orifice of the right pulmonary artery, in 3 patients. For closure, we used a patch of 0.4 mm Gore-Tex in 11, and gluteraldehyde-treated autologous pericardium in 5 of the patients. One patient died during surgery. The mean follow-up period for the surviving 15 patients was 52.2 months, with a range from 12 to 130 months. All the patients were in good condition during the follow-up, and no residual defects have been detected. Aortopulmonary window is a rare congenital cardiac anomaly, which can be repaired with very good operative results if surgery is performed before the development of irreversible pulmonary hypertension. We advise early correction of the defect with a transaortic patch, repairing all associated cardiac anomalies at the time of diagnosis.
Mert
Murat
M
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey. mmert@superonline.com
Paker
Tufan
T
Akcevin
Atif
A
Cetin
Gurkan
G
Ozkara
Ahmet
A
Saltik
Levent
L
Bakir
Ihsan
I
Yildiz
Cenk Eray
CE
D001028:Aortopulmonary Septal Defect / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011182:Postoperative Care; D016896:Treatment Outcome