Aortopulmonary Window Surgery Workup

Updated: Jun 24, 2021
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Suvro S Sett, MD, FRCSC, FACS  more...
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Workup

Laboratory Studies

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. Arterial blood gas (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

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 and evaluate associated conditions and congenital thoracic anomalies in neonates, infants and adults. [4, 8]

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Other Tests and Diagnostic Procedures

An electrocardiogram (ECG) reveals left and right ventricular hypertrophy.

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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