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Diagnosis, management, and results of treatment for aortopulmonary window

Published online by Cambridge University Press:  21 January 2005

Murat Mert ,
Tufan Paker ,
Atif Akcevin ,
Gurkan Cetin ,
Ahmet Ozkara ,
Levent Saltik ,
Ihsan Bakir  and
Cenk Eray Yildiz
Murat Mert
Affiliation:
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
Tufan Paker
Affiliation:
Department of Cardiovascular Surgery, Istanbul American Hospital, Istanbul, Turkey
Atif Akcevin
Affiliation:
Department of Cardiovascular Surgery, Istanbul American Hospital, Istanbul, Turkey
Gurkan Cetin
Affiliation:
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
Ahmet Ozkara
Affiliation:
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
Levent Saltik
Affiliation:
Department of Pediatric Cardiology, Institute of Cardiology, Istanbul University, Istanbul, Turkey
Ihsan Bakir
Affiliation:
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
Cenk Eray Yildiz
Affiliation:
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
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Abstract

The aortopulmonary window is a communication between the ascending aorta and the pulmonary trunk in the presence of two separate arterial valves. This uncommon congenital anomaly is reported rarely in the literature. We present here our experience with 16 patients, emphasizing the importance of early closure of the defect by a transaortic approach.

We performed surgery on 16 patients over a period of 13 years using a transaortic approach under cardiopulmonary bypass. The median age of the patients at the time of operation was 6.5 months, with a range from 1 month to 11 years. Preoperative pulmonary arterial systolic pressure ranged from 30 to 100 mmHg. Associated cardiac anomalies were present in 7 of the patients, and were repaired at the same stage. The defect was between the ascending aorta and the proximal pulmonary trunk in 13 patients, and between the ascending aorta and the distal pulmonary trunk, with overriding of the orifice of the right pulmonary artery, in 3 patients. For closure, we used a patch of 0.4 mm Gore-Tex in 11, and gluteraldehyde-treated autologous pericardium in 5 of the patients.

One patient died during surgery. The mean follow-up period for the surviving 15 patients was 52.2 months, with a range from 12 to 130 months. All the patients were in good condition during the follow-up, and no residual defects have been detected.

Aortopulmonary window is a rare congenital cardiac anomaly, which can be repaired with very good operative results if surgery is performed before the development of irreversible pulmonary hypertension. We advise early correction of the defect with a transaortic patch, repairing all associated cardiac anomalies at the time of diagnosis.

Keywords

Aortopulmonary fenestrationpulmonary hypertensiontransthoracic echocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 14 , Issue 5 , October 2004 , pp. 506 - 511
Copyright
© 2004 Cambridge University Press

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