Albuquerque Am

Aortopulmonary window. Clinical and surgical assessment of 18 cases

OBJECTIVE Aortopulmonary window (APW) is an uncommon congenital malformation. Its clinical presentation is dependent on the size of the defect and on the associated lesions. We evaluated our experience with this anomaly and compared it with 296 cases reported in the literature. METHODS Retrospective study of 18 patients diagnosed as having APW (age range from 13 days to 31 years, 13 (72.2%) females), divided into two groups: Group A (GA): 10 patients with isolated APW, and Group B (GB): 8 patients with associated lesions. RESULTS Heart failure occurred in 14 patients, and cyanosis in 3:2 from GB (tetralogy of Fallot--TF, and double outlet right ventricle--DORV), and one from GA with pulmonary hypertension. In 5 patients from GA the diagnosis of mitral regurgitation was made based on a systolic murmur and LV hypertrophy on the EKG. In GB, clinical findings were determined by the associated defect. Diagnosis was established by echocardiography in 11 (61.2%) of the patients. In 3 patients, a wrong diagnosis of mitral regurgitation was made, in 1 a patent ductus arteriosus was diagnosed and in 3 others, the diagnosis of APW was masked by other important associated defects (2 cases of DORV and 1 case of TF). The diagnosis was made by catheterization in 3 (16.6%) patients, by surgery in 3 (16.6%) and by necropsy in 1 (5.5%). Corrective surgery was performed in 14 (77.7%) patients, with one immediate death and good long-term follow-up in the remaining patients. CONCLUSION APW can be confused with other defects. Clinical findings, associated with an adequate echocardiogram can provide the information for the correct diagnosis.

Aortic atresia with aortopulmonary window and interrupted aortic arch, simulating common arterial trunk: a case report

The authors describe the cross-sectional echocardiographic and angiographic features besides the postmortem findings of a newborn with aortic atresia associated with the aortopulmonary window and an interrupted aortic arch, as the third known similar case reported in the literature. Anatomical and clinical similarities with common arterial trunk are emphasized and a more correct management is established to avoid risks, in which Norwood-type techniques would be preferable.

Aortic origin of right pulmonary artery: early detection by cross-sectional and color-Doppler-echocardiography in two infants submitted to successful surgical repair

The aortic origin of the right pulmonary artery was recognized in two infants by cross-sectional echocardiography. The sub-costal short axis view was sufficient to make the diagnosis. The Doppler and color-Doppler techniques were useful in adding the hemodynamic information to the anatomical diagnosis. Early surgical correction was performed in the infants with success without needing to resort to cardiac catheterization.