title: Aortopulmonary window and the interrupted aortic arch: midterm results with use of the single-patch technique.
abstract: BACKGROUND
  An aortopulmonary window (APW) associated with an interrupted aortic arch (IAA) can be associated with significant rates of perioperative mortality and recurrent arch obstruction. We assessed the outcomes associated with the use of a single pericardial patch technique for primary repair.
  
  
  METHODS
  Between 2002 and 2011, 9 neonates and 2 infants with APW and IAA underwent single-stage repair, under a hypothermic (28°C) continuous cardiopulmonary bypass with antegrade selective cerebral perfusion. A single autologous pericardial patch (glutaraldehyde-fixed) was used both to augment the IAA end-to-side anastomosis and to close the APW by use of the "sandwich" technique.
  
  
  RESULTS
  The IAA was type A in 6 patients and type B in 5 patients. The APW morphology was type I in 6 patients, type II in 4 patients, and type III in 1 patient. The median age and weight at operation were 11 days (range, 6 to 180 days) and 2.6 kg (range, 2.2 to 6.5 kg), respectively. The mean cardiopulmonary bypass and aortic cross-clamp times were 108.6 ± 27.5 minutes and 49.3 ± 13.4 minutes, respectively. One patient required additional closure of a ventricular septal defect. Delayed sternal closure was performed in 8 patients. The mean follow-up time was 6 ± 3 years. There were no early and no late deaths. Postoperative morbidity consisted of one postoperative stroke with no late sequelae. There were no reoperations. The last follow-up visits confirmed the absence of recurrent aortic arch obstruction and pulmonary artery branch stenosis in all patients.
  
  
  CONCLUSIONS
  Primary anatomic repair of APW associated with IAA can be safely performed. The efficiency of the single-patch technique was confirmed by the restoration of normal functional anatomy of the great arteries and aortic arch during follow-up.
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France. Electronic address: francois.roubertie@chu-bordeaux.fr.
authors.forename: François
authors.initials: F
authors.lastname: Roubertie
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France.
authors.forename: David
authors.initials: D
authors.lastname: Kalfa
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Vergnat
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ly
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lambert
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital/M3C, University Paris-Sud, Le Plessis-Robinson, France.
authors.forename: Emre
authors.initials: E
authors.lastname: Belli
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D001028:Aortopulmonary Septal Defect / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome