Aortic Reconstruction Using a Main Pulmonary Artery Flap in an Isolated Aortopulmonary Window / 대한흉부외과학회지

Aortopulmonary window (APW) is a rare cardiac anomaly that was reported to occur in only 43 cases over 33 years at a large-volume cardiac center. It can present as an isolated anomaly or in combination with another cardiac anomaly. The surgical technique for APW has evolved from simple ligation to separation of the 2 great arteries. However, because of the rarity of APW, there is no standard surgical treatment for this disease entity. Herein, we present successful aortic reconstruction using a main pulmonary artery flap after separation of the 2 great arteries in a neonate with isolated APW.

Surgical repair of complex aortopulmonary window: a case study

Abstract Aortopulmonary septal defect, also known as the aortopulmonary window, is a rare congenital macrovascular malformation. This case involves a 9-year-old boy with aortopulmonary septal defect (type I combined with type IV). Before surgery, milrinone and alprostadil were used to counteract high lung pressure. Surgery was performed under cardiopulmonary bypass, following which the pulmonary pressure decreased. The aorta was cut, and the right pulmonary artery opening was connected with the main pulmonary artery septal defect using polyester patch. An internal tunnel was made, and the deformity correction was completed. The child exhibited normal postoperative recovery with no discomfort. A complex aortopulmonary window is a rare condition that can be treated successfully with appropriate preoperative and surgical management.

One-Stage Repair of an Interrupted Aortic Arch with an Aortopulmonary Window in a Premature Neonate

Interrupted aortic arch with an aortopulmonary window is a rare congenital entity that is associated with high morbidity and mortality, especially in premature low-birth-weight infants, and the proper timing of surgical correction remains a matter of debate. We present the case of a premature infant weighing 1.6 kg who successfully underwent one stage surgical repair to treat interrupted aortic arch with an aortopulmonary window. The therapeutic management of this patient is described below, and a review of the literature is presented.

One case report of successfully occluded aortopulmonary septal defect in young infant / 临床儿科杂志

Objective To explore the method and efifcacy of intervention aortopulmonary septal defect (APSD) in young infant. Methods A four month old APSD infant had undergone interventional treatment using homemade ventricular septal de-fect occluder, and was followed up to observe the curative effect. Results The APSD had been successfully closured, and the clinical symptoms improved instantly. The follow-up showed heart function improved, heart shadow reduced, and growth well. Conclusions APSD interventional therapy is a safe, effective treatment in young infant.

Diagnosis Study Progress of Aortopulmonary Septal Defect / 实用儿科临床杂志

Aortopulmonary septal defect is a rare anomaly,it should be considered whenever the course of complex congenital heart di-sease includes early cardiac failure and pulmonary hypertension.So the importance of early correction to avoid irreversible pulmonary hypertension was emphasized.Noninvasive imaging with echocardiography and (or) 64MRSCT will adequately define the anatomy before surgery,it's necessary to perform cardiac catheterization to evaluate the reversability of pulmonary vessels when pulmonary hypertention is suspected.

Surgical correction of aortopulmonary septal defect in children / 中华胸心血管外科杂志

Objective To summarize experiences of surgical correction of aortopulmanary septal defect (APSD) in children. Methods Fifteen children with APSD,aged 5 months to 11 years,weighed 4.5 to 21.0kg,underwent surgical correction. Based on Richardson's classification,type I in 7 cases,type II in 3,and type III in 5. Eight cases were associated with other cardiac defects (53.5%),including 4 cases with complicated cardiac defects (26.7%). Operative technique included patch repair of defect in 8 cases with type I and II,an intraaotic synthetic baffle directed pulmonary blood from the APSD to the right pulmonary artery (RPA) in 3 cases with type III,an artificial conduit was used to connect the RPA with main pulmonary artery (MPA) and a flap of aortic wall was excised along with the anomalous RPA to extend the anastomosis in each case with type III,direct suture was used in 2 cases. Other associated cardiac defects were repaired simultaneously. Results The post-operative mortality rate was 6.7% (1/15). Eleven cases were followed-up from 3 months to 13 years in good condition. Conclusion APSD associated with complicated cardiac defects is apt to be misdiagnosed. Correct diagnosis can be made by 2-D echocardiography, cardiac catheterization angiography,and MRI. The operation should be done as early as possible once definite diagnosis is made. Operation should be done infancy to prevent development of pulmonary vascular disease. In type III APSD and APSD associated with complicated cardiac defects,operative mortalith is high. Preoperative accurate diagnosis and full understanding of the pathophysiology are the keys to an optimal surgical correction.

Anestesia en la ventana aorto-pulmonar

Se realiza un estudio retrospectivo de 9 niños menores de 2 años operados de ventana aorto-pulmonar en el Cardiocentro del Hospital Pediátrico Docente "William Soler", durante el período de 1986 a 1994. El fentanyl fue el agente más utilizado en la inducción de la anestesia (8 pacientes, 89 %) y se empleó en todos los pacientes durante el mantenimiento, lo que aportó gran estabilidad hemodinámica. Las complicaciones encontradas fueron el síndrome de bajo gasto cardíaco, broncoespasmo, hipertensión pulmonar y arritmias cardíacas. En todos los pacientes se utilizó el protocolo para el manejo de la hipertensión pulmonar. No hubo fallecidos durante el transoperatorio ni en el posoperatorio inmediato.

A retrospective study of 9 children under 2 operated on of aorto-pulmonary window at the Heart Center of "William Soler" Pediatric Teaching Hospital from 1986 to 1994 was conducted. Fentanyl was the most used agent in the induction of anesthesia (8 patients, 89 %) and it was administered to all patients during maintenance, which made possible a great hemodynamic stability. The complications found were the syndrome of low cardiac output, bronchospasm, pulmonary hypertension and cardiac arrhythmias. The protocol for the management of pulmonary hypertension was used with all patients. Deaths were not reported either during the transoperative or in the immediate postoperative.