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Aortopulmonary Window Surgery Workup

  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Jonah Odim, MD, PhD, MBA  more...
 
Updated: Jan 05, 2016
 

Laboratory Studies

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  • 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.
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Imaging Studies

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  • 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.[5]
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Other Tests

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  • An ECG reveals left and right ventricular hypertrophy.
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Diagnostic Procedures

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  • 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.
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Contributor Information and Disclosures
Author

Mary C Mancini, MD, PhD, MMM Professor and Chief of Cardiothoracic Surgery, Department of Surgery, Louisiana State University School of Medicine in Shreveport

Mary C Mancini, MD, PhD, MMM is a member of the following medical societies: American Association for Thoracic Surgery, American College of Surgeons, American Surgical Association, Society of Thoracic Surgeons, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Robert DB Jaquiss, MD Professor of Surgery, University of Arkansas for Medical Sciences; Chief, Pediatric Cardiothoracic Surgery, Arkansas Children's Hospital and Chief, Cardiothoracic Surgery, University of Arkansas for Medical Sciences

Robert DB Jaquiss, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for Thoracic Surgery, American College of Cardiology, American College of Surgeons, American Heart Association, Congenital Heart Surgeons Society, International Society for Heart and Lung Transplantation, Society of Thoracic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Jonah Odim, MD, PhD, MBA Section Chief of Clinical Transplantation, Transplantation Branch, Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)

Jonah Odim, MD, PhD, MBA is a member of the following medical societies: American College of Cardiology, American College of Chest Physicians, American Association for Physician Leadership, American College of Surgeons, American Heart Association, American Society for Artificial Internal Organs, American Society of Transplant Surgeons, Association for Academic Surgery, Association for Surgical Education, International Society for Heart and Lung Transplantation, National Medical Association, New York Academy of Sciences, Royal College of Physicians and Surgeons of Canada, Society of Critical Care Medicine, Society of Thoracic Surgeons, Canadian Cardiovascular Society

Disclosure: Nothing to disclose.

Additional Contributors

Daniel S Schwartz, MD, FACS Medical Director of Thoracic Oncology, St Catherine of Siena Medical Center, Catholic Health Services

Daniel S Schwartz, MD, FACS is a member of the following medical societies: Society of Thoracic Surgeons, Western Thoracic Surgical Association, American College of Chest Physicians, American College of Surgeons

Disclosure: Nothing to disclose.

Acknowledgements

Hani A Hennein, MD, FACS, FAAP, FCCP Associate Professor of Surgery and Pediatrics, Case Western Reserve University School of Medicine; Chief, Section of Pediatric Cardiothoracic Surgery, Department of Surgery, University Hospitals of Cleveland, Rainbow Babies and Childrens Hospital

Disclosure: Nothing to disclose.

Jeff L Myers, MD, PhD Chief, Pediatric and Congenital Cardiac Surgery, Department of Surgery, Massachusetts General Hospital; Associate Professor of Surgery, Harvard Medical School

Jeff L Myers, MD, PhD is a member of the following medical societies: American College of Surgeons, American Heart Association, and International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.

References
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