An alternative technique for septation of the aortopulmonary window using a fenestrated, unidirectional valved fabric patch

Novel Technique to Evaluate Pulmonary Vascular Resistance in a Patient With Aortopulmonary Window

“…In several small series, the calculated Qp:Qs and resistance ratios have improved with administration of nitric oxide and oxygen. 1,2,4,6 This is reassuring data to have when possible, but we suggest a less invasive method of evaluation. This method is not meant to replace catheterization data when available but rather to supplement it or to be used when reliable catheterization data cannot be obtained.…”

“…In this case, the lack of symptoms, combined with an X-ray that was not very impressive for pulmonary overcirculation, raised concerns for elevated PVR. If the patient had a fixed, elevated, PVR, then a fenestrated, valved flap closure would be an alternative repair as described by Chowdhury et al 6 A cardiac catheterization was contemplated to address this question, but we were concerned about the accuracy of catheterization data. Blood gas samples from the pulmonary arteries may not be adequately mixed and could vary depending on sample site.…”

Technical Details of Transwindow Fenestrated, Unidirectional, Valved, Aorticopulmonary Fabric Patch Closure of Aortopulmonary Window (UKC's Modification): A Video Presentation

“…21,22 In 2009, we published our preliminary experience using this novel modification of aortopulmonary septation for hypertensive aortopulmonary window with encouraging results. 23 We present herein a 10-year-old female patient diagnosed with isolated type I aortopulmonary window and severe pulmonary arterial hypertension who underwent repair of the aortopulmonary window via Johansson's transwindow approach using a unidirectional, fenestrated, valved, aorticopulmonary patch. 5,6 The preoperative pulmonary vascular resistance was 9.0 Woods units/m 2 that reduced to 4.0 Woods units/m 2 after oxygen (100%) and nitric oxide (80 ppm) administration.…”

“…21 22 In 2009, we published our preliminary experience using this novel modification of aortopulmonary septation for hypertensive aortopulmonary window with encouraging results. 23…”