Abstract
We have studied 14 patients with aortopulmonary window (10 male and 4 female, age range 1 month to 41 years). Four of these had a distal defect with characteristic haemodynamic and angiographic features. Aortopulmonary window may be classified into 3 types: type I (proximal) defects occur in the proximal part of aortopulmonary septum; type II (distal) defects occur in the distal part of the aortopulmonary septum adjacent to the right pulmonary artery; the type III defect is a combination of types I and II. In type I, injection of contrast media into the aortic root opacifies the main pulmonary trunk and then both pulmonary arteries. In type II, the right pulmonary artery is preferentially opacified simulating the finding of right pulmonary artery arising from the ascending aorta. In one case of type II, injection into the right ventricle showed preferential flow to the left pulmonary artery, because of the large shunt of unopacified blood into the right pulmonary artery, but in both types I and II the left and right pulmonary arteries are usually opacified simultaneously after injection into the main pulmonary trunk. In type I either transaortic or transpulmonary closure is the appropriate surgical procedure. In types II and III, the transaortic approach provides better exposure and facilitates the operative repair.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Agius P. V., Rushworth A., Connolly N. Anomalous origin of left coronary artery from pulmonary artery associated with an aorto-pulmonary septal defect. Br Heart J. 1970 Sep;32(5):708–710. doi: 10.1136/hrt.32.5.708. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BARONOFSKY I. D., GORDON A. J., GRISHMAN A., STEINFELD L., KREEL I. Aorticopulmonary septal defect; diagnosis and report of case successfully treated. Am J Cardiol. 1960 Feb;5:273–276. doi: 10.1016/0002-9149(60)90209-5. [DOI] [PubMed] [Google Scholar]
- BOSHER L. H., Jr, McCUE C. M. Diagnosis and surgical treatment of aortopulmonary fenestration. Circulation. 1962 Mar;25:456–462. doi: 10.1161/01.cir.25.3.456. [DOI] [PubMed] [Google Scholar]
- COOLEY D. A., MCNAMARA D. G., LATSON J. R. Aorticopulmonary septal defect: diagnosis and surgical treatment. Surgery. 1957 Jul;42(1):101-20; discussion, 120. [PubMed] [Google Scholar]
- Coleman E. N., Barclay R. S., Reid J. M., Stevenson J. G. Congenital aorto-pulmonary fistula combined with persistent ductus arteriosus. Br Heart J. 1967 Jul;29(4):571–576. doi: 10.1136/hrt.29.4.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Deverall P. B., Lincoln J. C., Aberdeen E., Bonham-Carter R. E., Waterston D. J. Aortopulmonary window. J Thorac Cardiovasc Surg. 1969 Apr;57(4):479–486. [PubMed] [Google Scholar]
- Hurwitz R. A., Ruttenberg H. D., Fonkalsrud E. Aortopulmonary window, ventricular spetal defect and mesoversion. Surgical correction in an infant. Am J Cardiol. 1967 Oct;20(4):566–570. doi: 10.1016/0002-9149(67)90036-7. [DOI] [PubMed] [Google Scholar]
- MORROW A. G., GREENFIELD L. J., BRAUNWALD E. Congenital aortopulmonary septal defect. Clinical and hemodynamic findings, surgical technic, and results of operative correction. Circulation. 1962 Mar;25:463–476. doi: 10.1161/01.cir.25.3.463. [DOI] [PubMed] [Google Scholar]
- NEUFELD H. N., LESTER R. G., ADAMS P., Jr, ANDERSON R. C., LILLEHEI C. W., EDWARDS J. E. Aorticopulmonary septal defect. Am J Cardiol. 1962 Jan;9:12–25. doi: 10.1016/0002-9149(62)90093-0. [DOI] [PubMed] [Google Scholar]
- Putnam T. C., Gross R. E. Surgical management of aortopulmonary fenestration. Surgery. 1966 May;59(5):727–735. [PubMed] [Google Scholar]