In this section
Provided by "Pediatric Heart Surgery — a reference for professionals"
Aortopulmonary window is a rare congenital heart defect in which there is communication between the ascending aorta and the main pulmonary artery above two distinct semilunar valves. This defect may vary in size, but it usually results in a large left-to-right shunt. The amount of shunting that occurs in patients with aortopulmonary window depends on the size of the aortopulmonary window and the relative vascular resistances in the systemic and pulmonary circulations. This left-to-right shunt results in increased pulmonary artery blood flow, left atrial and left ventricular volume overload, and right ventricular pressure overload. Clinical presentation is similar to that of a patient with a large ventricular septal defect or patent ductus arteriosus. Patients present with congestive heart failure and decreased cardiac output. If pulmonary vascular resistance is high, patients are at risk for early development of pulmonary vascular obstructive disease. Repair should be performed as early as possible once the diagnosis is made to avoid these complications.
Repair of aortopulmonary window requires cardiopulmonary bypass and aortic cross-clamping. The aorta or main pulmonary artery is opened, the aortopulmonary window defect is visualized, and a patch of synthetic material or pericardium is sutured in place to close the defect. Cardiopulmonary bypass time and aortic cross-clamp time required to repair this defect are short to moderate.