Transesophageal echocardiography in a distal aortopulmonary window

Abstract

Aortopulmonary window (APW) is a relatively rare cardiac lesion representing approximately 0.2%–0.4% of all cardiac malformation. It is a cardiac abnormality that results from abnormal communication between the proximal aorta and the main pulmonary artery in the presence of two normally separated aortic and pulmonary valves. In the past, the diagnostic and surgical approach to APW was almost always preceded by cardiac catheterization. With recent advances in noninvasive approach and techniques of two-dimensional echocardiography diagnosis of the defect and associated anomalies are facilitated without a cath study. We report a 4-month-old infant with a distal APW who was referred to our center for surgical repair. We emphasize the usage of transesophageal echocardiography as a valuable intraoperative tool which not only confirms the preoperative diagnosis but also helps in assessing the surgical repair of an APW.

The prenatal diagnosis of aortopulmonary window by fetal echocardiography

“…The severe hemodynamic abnormalities caused by the continuous biphasic shunt significantly increase volume load and pulmonary over circulation, resulting in advanced left ventricular dysfunction and congestive heart failure . The aortopulmonary septum defect should be closed immediately after diagnosis in all patients with APW . Therefore, prenatal diagnosis plays a very important role in the effective and timely treatment in these patients postpartum, thereby decreasing the mortality rate in neonates or infants.…”

A case of asymptomatic large aortopulmonary window in an adult: Role of cardiac CT, CMRI, and 3D printing technology

“…To our knowledge, very few “asymptomatic” adult cases have been reported in the literature ( 2 - 5 ). APW patients usually have associated cardiac disorders, such as an atrial septal defect, patent ductus arteriosus, ventricular septal defect, coronary artery anomaly, or tetralogy of Fallot ( 1 ). However, our patient had an isolated APW.…”

“…Aortopulmonary window (APW) is a very rare congenital heart disease, representing approximately 0.2% to 0.4% of all cardiac malformations ( 1 ). Presently described is an unusual case of a large, unrepaired APW, causing severe pulmonary arterial hypertension (PAH), in a 32-year-old female who had been asymptomatic until 31 years of age.…”