[Diagnostic problems of the aortopulmonary window].

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Context:

• Aortopulmonary window (APW) is a rare congenital heart defect.
• Type I APW involves a proximal defect between the aorta and pulmonary artery.
• Understanding associated lesions and surgical outcomes is crucial.

Purpose:

• To report clinical, diagnostic, and surgical findings in Type I APW patients.
• To evaluate the efficacy and safety of surgical interventions.
• To identify factors contributing to mortality.

Summary:

• Seven patients with Type I APW were analyzed over 14 years.
• Six patients had associated cardiac anomalies, including VSD, ASD, PDA, subaortic stenosis, anomalous pulmonary artery origin, and single ventricle.
• Retrograde aortography is key for defect localization.
• Five patients had surgery, with two survivors.
• Transaortic approach offers greater safety for surgical closure.
• High mortality is linked to pulmonary complications from excessive left-to-right shunting.

Impact:

• Highlights the complexity of Type I APW with associated lesions.
• Emphasizes the transaortic approach for safer surgical correction.
• Underscores the critical role of managing pulmonary complications to improve survival rates in APW patients.