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Ann Thorac Surg 1998;65:768-770
© 1998 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Surgical Management of Aortopulmonary Window

Department of Cardiac Surgery, Royal Group of Hospitals, Belfast, Northern Ireland, United Kingdom

Accepted for publication September 22, 1997.

Mr Gladstone, Royal Victoria Hospital, Grosvenor Rd, Belfast BT12 6BA, Northern Ireland.

Background. Aortopulmonary window is a rare anomaly, and a variety of surgical techniques have been described for its closure.

Methods. We treated 6 infants with aortopulmonary window between 1993 and 1995. Three had associated type A interrupted aortic arch, and another had a muscular ventricular septal defect. The diagnosis was made by echocardiography, confirmed by cardiac catheterization in 4 infants. In 1 very sick neonate with interrupted arch, diagnosis of the window was considerably delayed. In 4 patients, we closed the window by using a flap of pulmonary artery, which was reconstructed without using a patch. In 2 neonates with interrupted arch we anastomosed the mobilized descending aorta directly to the aortic defect of the aortopulmonary window, closing the pulmonary artery with a pericardial patch.

Results. There were no hospital deaths, and all patients are in New York Heart Association functional class I at a mean follow-up of 30 months. Echocardiography shows no significant distortion of the great vessels.

Conclusions. The techniques described achieve excellent results using only autologous tissues with the potential for normal growth.

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