OBJECTIVE: Aortopulmonary window (APW) is an uncommum congenital heart disease, with communication between the pulmonary artery (PA) and the ascending aorta in the presence of two separate semilunar valves. The objective of this sutdy is to show our institution experience, considering clinical and surgical aspects.
METHODS: Retrospective study, with patients diagnosed between 1986 and 2008; 33 patients with mean age of 19,6 months (13 days to 31 years) were admitted and diagnosed with APW, being 19(57,6%) females. Isolated APW was present in 17(51,5%) and with associated defcts in 16(48,5%) patients. Diagnosis was confirmed by echocardiogram in 21(63,6%), by angiographic study in 6(18,2%), by surgery in 5(15,2%) and in necropsy in 1(3%) patient. Moderate to severe mitral regurgitation was present in 9(27,3%) patients and 412%) had cyanosis. Type I APW was detected in 24(72,7%) and type II in 9(27,3%).
RESULTS: Twenty four(85,7%) patients were submitted to surgical treatment with 2(6%) deaths. All other patients had a favourable outcome, with good long term follow-up. All patients, but one, were operated on with CPB support, closing the APW with heterologous patch and correcting associated defects; most commom associated lesions were VSD in 6, ASD in 4, PDA and subaortic stenosis in 3.
CONCLUSION: The surgical results are satisfactory, with low morbidity; recomendation after initial diagnosis is to operate soon to avoid pulmonary irreversible sequelae. The presence of associated congenital heart lesions could facilitate the diagnosis.