Aortopulmonary Window Surgery Workup
- Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Jonah Odim, MD, PhD, MBA more...
See the list below:
- No specific laboratory studies are required for diagnosis of aortopulmonary window (APW). All patients should have a complete blood count and a type and screen in anticipation of surgery. ABG levels should be obtained in patients receiving mechanical ventilation; PCO2 and pO2 can both be manipulated to prevent pulmonary overcirculation.
See the list below:
- Echocardiography is usually sufficient for defining the extent of the defect and any associated anomalies.
- Chest radiography reveals cardiomegaly and pulmonary congestion.
- Computed tomography has been used to detect congenital thoracic anomalies in adults.
See the list below:
- An ECG reveals left and right ventricular hypertrophy.
See the list below:
- Cardiac catheterization is reserved for patients who present with aortopulmonary window later in life. Any patient older than 6 months is at risk for the development of pulmonary hypertension. If the pulmonary vascular resistance is elevated, test for reversibility with vasodilators such as oxygen or nitric oxide. Occasionally, patients with additional intracardiac abnormalities may require catheterization to fully define the anatomy.
Barnes ME, Mitchell ME, Tweddell JS. Aortopulmonary window. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2011. 14(1):67-74. [Medline].
Gross RE. Surgical closure of an aortic septal defect. Circulation. 1952 Jun. 5(6):858-63. [Medline].
Backer CL, Mavroudis C. Surgical management of aortopulmonary window: a 40-year experience. Eur J Cardiothorac Surg. 2002 May. 21(5):773-9. [Medline].
Roubertie F, Kalfa D, Vergnat M, Ly M, Lambert V, Belli E. Aortopulmonary window and the interrupted aortic arch: midterm results with use of the single-patch technique. Ann Thorac Surg. 2015 Jan. 99 (1):186-91. [Medline].
Yildirim A, Karabulut N, Dogan S, Herek D. Congenital thoracic arterial anomalies in adults: a CT overview. Diagn Interv Radiol. 2011 Oct 6. [Medline].
Naimo PS, Yong MS, d'Udekem Y, et al. Outcomes of aortopulmonary window repair in children: 33 years of experience. Ann Thorac Surg. 2014 Nov. 98 (5):1674-9. [Medline].
Berry TE, Bharati S, Muster AJ, et al. Distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and hypoplasia of the aortic isthmus: a newly recognized syndrome. Am J Cardiol. 1982 Jan. 49(1):108-16. [Medline].
Brown JW, Ruzmetov M, Okada Y, et al. Outcomes in patients with interrupted aortic arch and associated anomalies: a 20-year experience. Eur J Cardiothorac Surg. 2006 May. 29(5):666-73; discussion 673-4. [Medline].
Chen MR, Wu SJ. Images in cardiovascular medicine. Unclassified type of aortopulmonary window. Circulation. 2006 Apr 18. 113(15):e703-4. [Medline].
Daitoku K, Yamauchi S, Suzuki Y, Fukuda I. Right Pulmonary Artery Obstruction Is a Long-term Complication of Aortopulmonary Window Repair. Congenit Heart Dis. 2013 May 7. [Medline].
Das BB, Pauliks LB, Chan KC. Anatomically corrected malposition of the great arteries in the setting of aortopulmonary window associated with holoprosencephaly. Pediatr Cardiol. 2006 Jan-Feb. 27(1):175-6. [Medline].
Erez E, Dagan O, Georghiou GP, et al. Surgical management of aortopulmonary window and associated lesions. Ann Thorac Surg. 2004 Feb. 77(2):484-7. [Medline].
Greenway SC, Bradley TJ, Caldarone CA, et al. Aortopulmonary window with anomalous origin of the right coronary artery from the pulmonary artery: Two cases highlighting the importance of complete pre-operative echocardiographic evaluation of the coronary arteries in all conotruncal anomalies. Eur J Echocardiogr. 2005 Dec 12. [Medline].
Hew CC, Bacha EA, Zurakowski D, et al. Optimal surgical approach for repair of aortopulmonary window. Cardiol Young. 2001 Jul. 11(4):385-90. [Medline].
Kirby ML. Pulmonary atresia or persistent truncus arteriosus: is it important to make the distinction and how do we do it?. Circ Res. 2008 Aug 15. 103(4):337-9. [Medline].
Konstantinov IE, Karamlou T, Williams WG, et al. Surgical management of aortopulmonary window associated with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg. 2006 May. 131(5):1136-1141.e2. [Medline].
Peer SM, Donofrio MT, Gaur L, Sinha P. Tricuspid atresia with aortopulmonary window: challenges in achieving a balanced circulation. Interact Cardiovasc Thorac Surg. 2013 Aug. 17(2):441-3. [Medline]. [Full Text].
Prem Sekar R, Bhima Shankar PR, Cherian KM. Transcatheter closure of a residual aortopulmonary window through internal jugular vein access. Indian Heart J. 2012 Sep-Oct. 64(5):521-3. [Medline].
Talwar S, Garg P, Kothari SS, Gulati GS, Anderson RH, Airan B. Aortopulmonary window with the absence of left pulmonary artery. World J Pediatr Congenit Heart Surg. 2012 Jul 1. 3(3):389-91. [Medline].
Tkebuchava T, von Segesser LK, Vogt PR, et al. Congenital aortopulumonary window: diagnosis, surgical technique and long-term results. Eur J Cardiothorac Surg. 1997 Feb. 11(2):293-7. [Medline].
Trowitzsch E, Schneider M, Urban A, Asfour B. Congenital pulmonary sling, aorto-pulmonary window and pulmonary vein obstruction as a diagnostic and therapeutic challenge in an infant with VACTERL association. Clin Res Cardiol. 2006 Jun. 95(6):338-43. [Medline].
Valsangiacomo ER, Smallhorn JF. Images in cardiovascular medicine. Prenatal diagnosis of aortopulmonary window by fetal echocardiography. Circulation. 2002 Jun 18. 105(24):E192. [Medline]. [Full Text].
Van Praagh R, Van Praagh S. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications. A study of 57 necropsy cases. Am J Cardiol. 1965 Sep. 16(3):406-25. [Medline].
Wright JS, Freeman R, Johnston JB. Aorto-pulmonary fenestration. A technique of surgical management. J Thorac Cardiovasc Surg. 1968 Feb. 55(2):280-3. [Medline].