Operative Repair of Aortopulmonary Window: A 25-Year Experience.

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Aortopulmonary window (APW) is a rare congenital heart defect with diverse presentations.
• Associated cardiovascular anomalies are common in patients with APW.
• Understanding factors influencing APW repair outcomes is crucial for patient management.

Purpose of the Study:

• To evaluate the mid-term outcomes of surgical repair for aortopulmonary window (APW).
• To identify patient and operative factors impacting postoperative length of stay and reintervention rates.
• To assess the durability and functional status following APW repair.

Main Methods:

• A retrospective review of 29 patients who underwent surgical APW repair between 1996 and 2022.
• Classification of APW into simple and complex types based on associated anomalies.
• Analysis of operative techniques, patient demographics, comorbidities, and postoperative outcomes including reinterventions and functional status.

Main Results:

• Excellent mid-term survival and functional status were observed, with no residual APW or persistent pulmonary hypertension at follow-up.
• Complex APW, genetic syndromes, noncardiovascular comorbidities, and lower weights were associated with longer postoperative length of stay.
• Reintervention-free survival was comparable across different APW complexities, operative ages, and repair techniques.

Conclusions:

• Surgical repair of APW offers excellent mid-term durability and functional outcomes.
• While comorbidities may prolong hospitalization, they do not appear to negatively impact long-term reintervention-free survival.
• The findings support the efficacy of surgical APW repair irrespective of patient or operative variables.