title: Outcomes of aortopulmonary window repair in children: 33 years of experience.
abstract: BACKGROUND
  The purpose of this study was to assess the outcomes of children undergoing repair of aortopulmonary window (APW).
  
  
  METHODS
  We conducted a retrospective review of all children (n=43) who underwent surgical repair of APW between 1980 and 2013.
  
  
  RESULTS
  Median age at surgery was 40 days (range, 13 to 125). Simple APW was present in 15 of 43 patients (35%), and 28 of 43 patients (65%) patients had concomitant cardiovascular anomalies. The aorta was repaired by direct suturing in 36 patients (84%) patients and patching in 7 patients (16%). The main pulmonary artery was repaired by direct suturing in 22 patients (51%) patients and by patching in 21 (49%). Cardiopulmonary bypass was used in 42 of the 43 patients (97.7%). Single-staged repair of concomitant cardiovascular anomalies was undertaken in 26 of 28 patients (93%). Only 2 of the 28 patients (7%) underwent repair of interrupted aortic arch before APW repair. Operative mortality was 6.7% (1 of 15 patients) among patients with simple APW and 18% (5 of 28 patients) among patients with concomitant anomalies. Operative weight less than 2.5 kg was associated with mortality on univariable analysis (p=0.02). Median follow-up was 10.1 years (range, 0.17 to 24.2). There were no late deaths. Overall survival was 86% (95% confidence interval: 71.3 to 94.2) at 10 years. Freedom from reoperation was 95.3% (95% confidence interval: 86.2 to 99.9) at 10 years. At last follow-up, all patients were in New York Heart Association functional class I/II.
  
  
  CONCLUSIONS
  Survival beyond discharge from the hospital is associated with excellent outcomes.
authors.affiliation: Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia.
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Naimo
authors.affiliation: Royal Children's Hospital, Melbourne, Australia.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Yong
authors.affiliation: Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Yves
authors.initials: Y
authors.lastname: d'Udekem
authors.affiliation: Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Brizard
authors.affiliation: Women's and Children's Hospital, Adelaide, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kelly
authors.affiliation: Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Weintraub
authors.affiliation: Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: igor.konstantinov@rch.org.au.
authors.forename: Igor E
authors.initials: IE
authors.lastname: Konstantinov
mesh_terms: D001028:Aortopulmonary Septal Defect / Q000401:mortality / Q000601:surgery*; D001315:Australia / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D016001:Confidence Intervals; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome