ISSN : 2146-3123
E-ISSN : 2146-3131

Diagnosis, Treatment and Outcomes of Patients with Aortopulmonary Window
İbrahim Halil Demir 1, Abdullah Erdem 1, Türkay Sarıtaş 1, Fadli Demir 1, Nurdan Erol 1, İlker Kemal Yücel 1, Ahmet Çelebi 1, Numan Ali Aydemir 2
1Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5152/balkanmedj.2013.6995
Pages : 191-196

Abstract

Background: Aortopulmonary window (APW) is a communication between the ascending aorta and the pulmonary artery in the presence of two separate semilunar valves and is the rarest of septal defects.

Aims: To present  our experience with the diagnosis and outcome of APW cases.

Study Design: Retrospective cohort study.

Methods: Between June 2003 and October 2011, thirteen patients were diagnosed with APW. Clinical features of patients, findings of echocardiographic and angiographic examination, results of surgical intervention and follow-up were reviewed retrospectively. 

Results: Eleven children (10 days to 16 years), underwent surgical correction of APW. In a 12-month-old boy, the defect was repaired by the transcatheter approach. In addition to APW repair, closure of VSD was performed in 2 patients. APW were associated with interruption in two patients; one also had a complex pathology. None of the patients died due to complications of surgical or transcatheter procedures. After a median follow-up period of 40 months, the patients were asymptomatic and none of them required additional medication, except for the patient with complex pathology including an interrupted aortic arch, who underwent balloon angioplasty for recoarctation.

Conclusion: In any infant with the findings of congestive heart failure and failure to thrive, APW must be kept in mind as a differential diagnosis. In isolated APW cases before 6 months of age, echocardiography is often sufficient for diagnosis. In complex cases, cardiac catheterisation is performed for the comprehensive evaluation of associated defects. After 6 months, cardiac catheterisation could be utilised to perform vasoreactivity testing and, if possible, to close the defect. 

Keywords : Aortopulmonary window, pulmonary hypertension, aortopulmonary septal defect
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