[Echocardiographic diagnosis of the aorto-pulmonary window].
PURPOSE/MATERIALS AND METHODS: The aorto-pulmonary window is a rare congenital cardiac malformation consisting of a connection between the ascending aorta and the main pulmonary artery. Based on 5 consecutive patients who were treated in our tertiary referral centre between 7/2000 and 11/2005, we report the echocardiographic features as well the limitations of this diagnostic method in the assessment of this rare malformation.


RESULTS
Dilation of the left atrium and ventricle due to the large left-to-right-shunt was the characteristic echocardiographic feature in all patients with aorto-pulmonary window. In all patients we were able to visualise the window by 2D-echocardiography. Pulsed- and continuous-wave Doppler showed diastolic negative flow in the descending aorta and in systemic arteries due to left-to-right shunting in diastole via the aorto-pulmonary window. All 5 patients had significant associated cardiovascular malformations. They were accurately diagnosed by echocardiography. Coronary anomalies could be excluded noninvasively in all patients.


CONCLUSIONS
Echocardiography is the method of choice for diagnosis of aortopulmonary window. Detection of aortopulmonary window, however, requires a systematic and careful investigation of all cardiovascular anatomic details, since this anomaly is frequently associated with substantial additional cardiac anomalies, which would by themselves be sufficient to explain the haemodynamic abnormalities of the patient. Cardiac catheterisation is required only in cases with inadequate information about coronary artery anatomy or in older patients with pulmonary hypertension, to determine the patient's suitability for surgical correction.
Apitz
C
C
Abteilung Kinderheilkunde II (Kardiologie, Intensivmedizin, Pulmologie), Universitätsklinikum Tübingen. christian.apitz@med.uni-tuebingen.de
Kaulitz
R
R
Sieverding
L
L
Girisch
M
M
Salehi-Gilani
S
S
Ziemer
G
G
Hofbeck
M
M
D001013:Aorta, Thoracic / Q000002:abnormalities; D001028:Aortopulmonary Septal Defect / Q000000981:diagnostic imaging* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006349:Heart Valve Diseases / Q000151:congenital / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler