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Surgical Repair of Aortopulmonary Window: Thirty-Seven Years of Experience

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Abstract

An aortopulmonary window (APW) is a communication between the ascending aorta and the pulmonary trunk in the presence of two separate semilunar valves. In order to increase our understanding about the surgical management of this rare lesion and its long-term results, we describe our experience over a 37-year period. Between 1968 and 2005, 18 patients were diagnosed with APW. Seventeen underwent surgical correction. Age at operation ranged from 22 days to 22 years (median, 0.20 years). Follow-up ranged from 2 weeks to 28.6 years (median, 11.0 years). Surgical closure was achieved using a single patch in 7 patients (41.2%) double patch in 4 (23.5%), primary closure in 3 (17.6%), clip in 2 (11.8%), and ligation in 1 (5.9%). Complex APW was present in 8 patients (44.4%). One patient was treated nonsurgically. There were no early or late deaths after surgery. Both primary closure and patch closure gave excellent long-term results. Sporadic postoperative complications were only associated with complex lesions. One patient who was treated conservatively died (of pulmonary hypertension) 21 years after diagnosis. Repair of APW is ideally performed in the first months of life, before irreversible PHT has developed. Various surgical repair techniques in this series of patients gave excellent short-term and long-term results, without significant hemodynamic sequelae.

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Authors and Affiliations

  1. Department of Pediatrics, VU Medical Center, Center for Congenital Anomalies of the Heart Amsterdam/Leiden, Amsterdam, The Netherlands

    C. Jansen, J. Hruda & L. Rammeloo

  2. Department of Cardiothoracic Surgery and Pediatric Cardiology, Center for Congenital Anomalies of the Heart Amsterdam/Leiden, Emma Children’s Hospital/Academic Medical Center, Amsterdam, The Netherlands

    J. Ottenkamp & M.G. Hazekamp

  3. Leiden University Medical Center, Leiden, The Netherlands

    J. Ottenkamp & M.G. Hazekamp

  4. Department of Cardiothoracic Surgery D6-26, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, The Netherlands

    M.G. Hazekamp

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  1. C. Jansen
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  2. J. Hruda
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  3. L. Rammeloo
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  4. J. Ottenkamp
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  5. M.G. Hazekamp
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Correspondence to M.G. Hazekamp.

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Jansen, C., Hruda, J., Rammeloo, L. et al. Surgical Repair of Aortopulmonary Window: Thirty-Seven Years of Experience. Pediatr Cardiol 27, 552–556 (2006). https://doi.org/10.1007/s00246-006-1297-0

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  • DOI: https://doi.org/10.1007/s00246-006-1297-0

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