Aortopulmonary Window: A New Operative Approach

Transesophageal echocardiography in a distal aortopulmonary window

“…Successful repair of an APW was reported from several years ago, and many authors have reported their results. The spectrum of the surgical techniques which evolved with time include simple ligation,[6] division and suturing without CPB, division and suturing with CPB, trans-PA closure using CPB,[7] trans-window closure (anterior sandwich patch closure), transaortic direct closure;[8] to transaortic patch closure of the defect;[9] using CPB and arresting the heart. First successful repair of an APW using CPB was reported in 1957.…”

Aortopulmonary Window in Adults: Diagnosis and Treatment of Late-presenting Patients

“…This technique was originally described by Negre et al 7 ,. although it was popularized by Johannson et al 8 …”

“…It gives good visualization of the lesion and makes it easy to exclude associated abnormalities such as anomalous coronary artery from the pulmonary artery. It also reduces the possibility of postsurgical stenosis of the great arteries, as may occur with other techniques 8 . The smaller cases were treated off‐pump.…”

“…Surgical correction was successfully carried out by the anterior sandwich patch technique for the large APWs. This technique was originally described by Negre et al 7 , although it was popularized by Johannson et al 8 . It gives good visualization of the lesion and makes it easy to exclude associated abnormalities such as anomalous coronary artery from the pulmonary artery.…”

“…It also reduces the possibility of postsurgical stenosis of the great arteries, as may occur with other techniques. 8 The smaller cases were treated off-pump. This removes the morbidity associated with cardiopulmonary bypass, although this must be balanced with the greater risk of leaving a residual shunt.…”