[Diagnostic problems of the aortopulmonary window]

Seven patients with aortopulmonary window type I (proximal) were studied over a period of 14 years. This report includes clinical, electrocardiographic, radiographic, cardiac catheterization and angiocardiographic data on the patients. Associated lesions were present in 6 patients: ventricular septal defect (1 case), atrial septal defect ostium secundum (1 case), persistent ductus arteriosus (1 case), membranous subaortic stenosis (1 case), aortic origin of the righ pulmonary artery (1 case) and single ventricle (1 case). Retrograde aortography is the most useful investigation in determining the precise location of the defect. Five patients underwent surgery but only two survive. Transaortic approach is the greater safety for surgical closure of the defect. The high mortality rate is the result of pulmonary complications caused by an excessive left-to-right shunt.