Aortopulmonary Window Repair: 15-Year Surgical Experience

Abstract

Aortopulmonary window is an uncommon anomaly. Early surgery is recommended before permanent pulmonary vascular changes develop. Results were reviewed in 18 patients who underwent aortopulmonary window repair between January 1985 and December 1999. A transaortic approach was employed in 12, a transpulmonary approach was used in 3, the pulmonary artery flap technique was performed in 2, and an aortopulmonary window was simply ligated in 1 patient. Concomitant repair of all associated anomalies was carried out, except in 2 patients who had interrupted aortic arch repaired 6 days before aortopulmonary window repair. There was no hospital mortality. During a mean follow-up of 43 months (range, 6 to 144 months), there was no late death and all patients were in New York Heart Association functional class I, except 3 who required reoperation: 2 had pulmonary artery confluence stenosis 5 to 10 years after aortopulmonary window repair; and 1 required transfer of the right coronary artery from the pulmonary artery to the aorta 28 months after aortopulmonary window repair. Surgical repair of aortopulmonary window, even when associated with other cardiac anomalies, carries a low risk. Early surgical treatment achieved excellent immediate and long-term results.