SURGICAL-MANAGEMENT OF AORTOPULMONARY WINDOW

Background. Aortopulmonary window is a rare anomaly, and a variety of surgical techniques have been described for its closure, Methods. We t reated 6 infants with aortopulmonary window between 1993 and 1995, Thr ee had associated type A interrupted aortic arch, and another had a mu scular ventricular septal defect, The diagnosis was made by echocardio graphy, confirmed by cardiac catheterization in 4 infants. In 1 very s ick neonate with interrupted arch, diagnosis of the window was conside rably delayed, In 4 patients, we closed the window by using a flap of pulmonary artery, which was reconstructed without using a patch. In 2 neonates with interrupted arch we anastomosed the mobilized descending aorta directly to the aortic defect of the aortopulmonary window, clo sing the pulmonary artery with a pericardial patch. Results. There wer e no hospital deaths, and all patients are in New York Heart Associati on functional class I at a mean follow-up of 30 months. Echocardiograp hy shows no significant distortion of the great vessels. Conclusions. The techniques described achieve excellent results using only autologo us tissues with the potential for normal growth. (C) 1998 by The Socie ty of Thoracic Surgeons.