Korean J Thorac Cardiovasc Surg.  2006 Apr;39(4):275-280.

Aortopulmonary Window

• Lee JR
• Kim DJ
• Min SK
• Kim WH
• Lee JS
• Kim YJ

Abstract

BACKGROUND: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. MATERIAL AND METHOD: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was 157.8+/-245.3 (15.0~994.0) days and mean weight was 4.8+/-2.5 (1.7~10.7) kg. Patent ductus arteriosus (8), atrial septal defect (7), interrupted aortic arch (5), ventricular septal defect (4), patent foramen ovale (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. RESULT: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was 6.8+/-5.6 (57.0 days~16.7 years)years and all patients belonged to NYHA class I.
CONCLUSION
With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

Keyword

Aortopulmonary window; Congenital heart disease

MeSH Terms

Aorta
Aorta, Thoracic
Aortic Coarctation
Aortic Valve
Bronchi
Constriction, Pathologic
Dextrocardia
Diagnosis
Ductus Arteriosus, Patent
Follow-Up Studies
Foramen Ovale, Patent
Heart
Heart Defects, Congenital
Heart Septal Defects, Atrial
Heart Septal Defects, Ventricular
Hemorrhage
Humans
Intensive Care Units
Length of Stay
Mitral Valve Insufficiency
Pulmonary Artery
Reoperation
Tracheal Stenosis
Tricuspid Valve Insufficiency
Vena Cava, Superior