RESUMEN
A 4-year-old female was diagnosed with Type II Aortopulmonary window after being seen for a murmur. By utilizing multimodality advanced imaging, including 2D and 3D echo, computed tomography (CTA) with semi-transparent overlay as a road map, we were able to preoperatively plan camera angles and device selection as well as close the defect percutaneously under echocardiography guidance. This report highlights the importance of a multimodality imaging approach to interventional procedures.
Asunto(s)
Defecto del Tabique Aortopulmonar , Ecocardiografía Tridimensional , Femenino , Humanos , Preescolar , Angiografía por Tomografía Computarizada , Angiografía , Ecocardiografía/métodos , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugíaRESUMEN
Aortopulmonary window is a condition characterized by a communication between the pulmonary artery and the ascending aorta. The coexistence of aortopulmonary window and an anomalous right coronary artery originating from the pulmonary artery is rarely observed together, as mentioned in previous studies. In this report, we aim to describe our diagnostic and treatment experiences with a 6-year-old patient diagnosed with aortopulmonary window associated with an abnormal origin of the right coronary artery from the pulmonary artery.
Asunto(s)
Defecto del Tabique Aortopulmonar , Anomalías de los Vasos Coronarios , Humanos , Niño , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/anomalías , Enfermedades Raras/complicaciones , Anomalías de los Vasos Coronarios/complicaciones , Anomalías de los Vasos Coronarios/diagnóstico , Defecto del Tabique Aortopulmonar/diagnóstico , Defecto del Tabique Aortopulmonar/diagnóstico por imagenRESUMEN
Congenital mitral stenosis is a broad-spectrum pathology in which blood flow to the left ventricle is obstructed both functionally and anatomically. Hammock mitral valve, also known as anomalous mitral arcade, is a rare congenital anomaly particularly in infants and children. Hammock mitral valve may not be suitable for repair regarding the advanced dysplastic mitral valve structure. Aortopulmonary window is an unusual cardiac anomaly which is defined as a communication between the main pulmonary artery and the ascending aorta. As a result of the excessive left-to-right shunt, early intervention and surgical closure deemed mandatory to avoid development of severe pulmonary hypertension and its consequences. All patients with an aortopulmonary window necessitates prompt repair immediately. In this brief report, mitral valve replacement with a mechanical valve and repair of aortopulmonary window with a Dacron patch were performed simultaneously in a 5-month-old patient with a hammock mitral valve and accompanying aortopulmonary window.
Asunto(s)
Defecto del Tabique Aortopulmonar , Insuficiencia de la Válvula Mitral , Estenosis de la Válvula Mitral , Lactante , Niño , Humanos , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Válvula Mitral/anomalías , Defecto del Tabique Aortopulmonar/diagnóstico , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Estenosis de la Válvula Mitral/complicaciones , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Arteria Pulmonar/anomalías , Insuficiencia de la Válvula Mitral/complicaciones , Insuficiencia de la Válvula Mitral/diagnóstico , Insuficiencia de la Válvula Mitral/cirugíaRESUMEN
We report a case of a 4-year-old boy with a distal type of aortopulmonary window with crossed arrangement of the pulmonary arteries. This case highlights the potential clinical implications of this variant pulmonary arterial anatomy in the setting of the aortopulmonary window and the role of computed tomography angiography in accurately defining vascular relationships in patients with complex congenital cardiac defects.
Asunto(s)
Defecto del Tabique Aortopulmonar , Arteria Pulmonar , Angiografía , Defecto del Tabique Aortopulmonar/complicaciones , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Preescolar , Humanos , Masculino , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugíaRESUMEN
Anomalous ascending aortic origin of left pulmonary artery in association with aortopulmonary window has not been reported so far in literature and is the main highlight of the present case.
Asunto(s)
Defecto del Tabique Aortopulmonar , Arteria Pulmonar , Aorta/anomalías , Aorta/diagnóstico por imagen , Aorta/cirugía , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Humanos , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugíaRESUMEN
AIM: The present study sought to evaluate the morphology and associated cardiovascular anomalies in patients with aortopulmonary window on virtual dissection of multidetector computed tomography (CT) angiography data sets. MATERIAL AND METHODS: We conducted a retrospective search of our departmental database from January 2014 to September 2021 to identify patients with aortopulmonary window and relevant information was extracted from the electronic case records and from routine examination as well as virtual dissection of CT data sets. RESULTS: An aortopulmonary window was observed in 26 patients (20 males; 6 females). Based on location of the defect, a distal aortopulmonary window was the most common subtype, seen in 13/26 (50%) patients followed by a proximal, complete and intermediate subtypes seen in 7/26 (27%), 5/26 (19%) and 1/26 (4%) patients respectively. Associated ventricular septal defect was observed in 9/26 (34.6%) patients while an interrupted aortic arch was present in 5/26 (19.2%) patients. Tetralogy of Fallot was seen in 5/26 (19.2%) patients. Anomalous origin of right pulmonary artery from ascending aorta and crossed pulmonary arteries were seen in 2/26 (7.6%) patients each. An isolated aortopulmonary window without any simple/complex congenital anomaly was seen in 10/26 (38.5%) patients. CONCLUSION: Aortopulmonary window is associated with a wide gamut of cardiovascular lesions, with ventricular septal defect being the commonest associated anomaly followed by tetralogy of Fallot and interrupted aortic arch respectively. Virtual dissection of multidetector CT angiography allows detailed anatomical evaluation of aortopulmonary window, allowing a clear visualization of the defect and associated cardiovascular anomalies.
Asunto(s)
Coartación Aórtica , Defecto del Tabique Aortopulmonar , Anomalías Cardiovasculares , Defectos del Tabique Interventricular , Tetralogía de Fallot , Masculino , Femenino , Humanos , Tomografía Computarizada Multidetector , Estudios Retrospectivos , Tetralogía de Fallot/complicaciones , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Defecto del Tabique Aortopulmonar/complicaciones , Arteria Pulmonar/cirugía , Coartación Aórtica/cirugía , Anomalías Cardiovasculares/complicaciones , Angiografía , Defectos del Tabique Interventricular/diagnóstico por imagen , Defectos del Tabique Interventricular/cirugía , Defectos del Tabique Interventricular/complicacionesRESUMEN
We present a case of aortopulmonary window in which the diagnosis of anomalous left coronary artery originating from pulmonary artery was made intra-operatively even if the coronary arteries anatomy was correctly studied pre-operatively with echocardiography. No evidence of coronary anomalies or indirect sings of coronary anomalies has been noted. Should we improve our pre-operative diagnostic accuracy and how?
Asunto(s)
Defecto del Tabique Aortopulmonar , Anomalías de los Vasos Coronarios , Humanos , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anomalías de los Vasos Coronarios/cirugía , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Arteria Pulmonar/anomalías , Ecocardiografía , CorazónRESUMEN
Coronary artery anomalies may accompany the aortopulmonary window and, if not noticed, may cause catastrophic consequences. The repair of the aortopulmonary window is quite straightforward; however, establishing a normal coronary pattern may challenge the repair. When the anomalous origin of the coronary artery is on the defect rim, right at the location where sutures are to be placed, it may interfere with proper suture placement. A technique to overcome such a technical obstacle and reroute the anomalous right coronary in such cases is described.
Asunto(s)
Defecto del Tabique Aortopulmonar , Anomalías de los Vasos Coronarios , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anomalías de los Vasos Coronarios/cirugía , Corazón , Humanos , Recién Nacido , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugíaRESUMEN
Aortopulmonary window (APW) is a rare but serious congenital cardiac malformation, most patients with APW will die from congestive heart failure within one year after birth. In fact, patients with large APW is rarely seen in childhood or adult life. However, we report an older child with a large anomalous "window" on the ascending aorta, with discontinuous pulmonary arteries, and the left pulmonary artery (LPA) arising via a left-sided arterial duct in the presence of a right aortic arch. Preoperative diagnosis made by echocardiography and chest computerized tomography revealed anatomical futures clearly. Cardiac catheterization indicated that the pulmonary resistances indices were 2.92 Wood unit/m2 in LPA and 3.35 Wood unit/m2 in RPA, Q p : Q s was 3.26. This patient underwent surgical correction at the age of 10 and successfully survived.
Asunto(s)
Defecto del Tabique Aortopulmonar , Arteria Pulmonar , Adolescente , Adulto , Aorta , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Niño , Ecocardiografía , Humanos , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugíaRESUMEN
We described a very rare case of aorto-pulmonary communication with right aortic arch and crossed pulmonary artery that cannot be placed in the typical anatomic classification of aortopulmonary window. At 23 weeks gestation, fetal echocardiography revealed a large tunnel-like communication connecting the great vessels proximal to the main pulmonary artery bifurcation, rather than a classic aortopulmonary window between the ascending aorta and the main pulmonary artery.
Asunto(s)
Defecto del Tabique Aortopulmonar , Aorta/diagnóstico por imagen , Aorta Torácica/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Femenino , Humanos , Embarazo , Diagnóstico Prenatal , Arteria Pulmonar/diagnóstico por imagenRESUMEN
Anomalous origin of coronary artery originating from the pulmonary artery in conjunction with the aorticopulmonary window (APW) is a rare but a significant anomaly in the era of congenital cardiac diseases. The occurrence of anomalous origin of the right coronary artery from the pulmonary artery among the associated anomalies is less than 5%. The severity of the clinical condition of these patients depends on the degree of left-right shunt and compromise of the pulmonary blood flow. We report surgical management of a case of a 45-day-old infant with APW, ventricular septal defect, and anomalous origin of coronary artery originated from the pulmonary artery.
Asunto(s)
Defecto del Tabique Aortopulmonar , Anomalías de los Vasos Coronarios , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anomalías de los Vasos Coronarios/cirugía , Humanos , Lactante , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Circulación PulmonarRESUMEN
Aorto-pulmonary window (APW) is a rare congenital heart defect characterized by the connection between the ascending aorta and the pulmonary trunk before its bifurcation, just above the semilunar valves, due to the abnormal development of spiral septum. The short-axis echocardiographic view of the right ventricular outflow track, the three-vessel-view, and the three-vessel-trachea view are the key planes for prenatal diagnosis. We report a case of APW with absent ductus arteriosus in a monochorionic twin, detected by prenatal echocardiography. The diagnosis was confirmed postnatally and corrective surgery was performed at the age of 1 week. Prenatal diagnosis of APW is essential, since surgical correction early after birth is required to prevent congestive heart failure secondary to high pulmonary blood flow.
Asunto(s)
Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Conducto Arterial/diagnóstico por imagen , Ecocardiografía , Ultrasonografía Prenatal , Adulto , Aorta/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Femenino , Humanos , EmbarazoRESUMEN
A 10-day-old infant was evaluated for heart failure and differential cyanosis. Type A interrupted aortic arch with duct-dependent lower body circulation was identified. There was associated type 2 aortopulmonary window which led to a "Valentine on a crab" appearance on echocardiography. Pattern recognition in imaging is useful for early identification of anomalies and for triaging appropriate evaluation and management.
Asunto(s)
Aorta Torácica , Defecto del Tabique Aortopulmonar , Aorta Torácica/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/cirugía , Ecocardiografía , Humanos , LactanteRESUMEN
Aortopulmonary window (APW) is a rare congenital cardiac condition. A large number of patients with a large APW usually die within 1 year of age. It is extremely rare to find cases of APW surviving till adult age and it is still rare to surgically treat such patients who are incidentally detected in adult age because such subsets of patients invariably have associated pulmonary vascular obstructive disease in advanced stage and thus there is therapeutic dilemma to surgically correct these patients. Although cases of uncorrected AP window presenting in adulthood have been reported but literature on surgically treated AP window in adult populations is limited. We describe case of APW in a 26-year-old male patient who was diagnosed incidentally while suspecting infective endocarditis and was subsequently surgically closed successfully with polytetrafluoroethylene patch after confirming reversibility of pulmonary arterial hypertension which is the key for successful outcome.
Asunto(s)
Defecto del Tabique Aortopulmonar/cirugía , Procedimientos Quirúrgicos Cardiovasculares/métodos , Hallazgos Incidentales , Hipertensión Arterial Pulmonar/etiología , Hipertensión Arterial Pulmonar/cirugía , Adulto , Defecto del Tabique Aortopulmonar/complicaciones , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Ecocardiografía Transesofágica , Humanos , Masculino , Politetrafluoroetileno , Enfermedades Raras , Resultado del TratamientoRESUMEN
Aortopulmonary window is a rare cardiac defect, and early management with surgery or transcatheter closure is lifesaving. Here, a 9-month-old patient, who underwent a successful device closure with additional size-Amplatzer duct occlude, is presented to make emphasis that it may be considered as the device of choice for defects in close proximity to aortic valve and/or coronary ostium.
Asunto(s)
Aorta/fisiopatología , Defecto del Tabique Aortopulmonar/cirugía , Cateterismo Cardíaco/instrumentación , Dispositivo Oclusor Septal , Angiografía , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Femenino , Humanos , Lactante , Diseño de Prótesis , Resultado del TratamientoRESUMEN
Aortopulmonary window with interrupted aortic arch is rarely reported beyond infancy. Pre-operative assessment and surgical repair are challenging. We report successful surgical repair of aortopulmonary window with interrupted aortic arch in a 6-year-old girl with near-normal pulmonary artery pressure immediately following surgery.
Asunto(s)
Aorta Torácica/anomalías , Defecto del Tabique Aortopulmonar/cirugía , Aorta Torácica/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Defecto del Tabique Aortopulmonar/fisiopatología , Procedimientos Quirúrgicos Cardíacos/métodos , Niño , Angiografía por Tomografía Computarizada , Femenino , Humanos , Hipertensión Pulmonar/etiología , Arteria Pulmonar/anomalías , Arteria Pulmonar/cirugía , Presión Esfenoidal Pulmonar , Resultado del TratamientoRESUMEN
An aortopulmonary window (APW) is a rare congenital heart defect involving an abnormal communication between the ascending aorta and the pulmonary trunk with separate aortic and pulmonary valves. This defect accounts for 0.2% of all congenital cardiac anomalies and if left untreated can lead to Eisenmenger syndrome, severe pulmonary hypertension, heart failure, and poor survival. The authors herein present a case of APW type III with Eisenmenger syndrome in an adult patient whose initial complaint was cyanosis, and provide a thorough review of the literature of cases of APW with Eisenmenger syndrome that have survived into adulthood.
Asunto(s)
Defecto del Tabique Aortopulmonar/complicaciones , Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Ecocardiografía/métodos , Complejo de Eisenmenger/diagnóstico por imagen , Complejo de Eisenmenger/etiología , Adulto , HumanosRESUMEN
Aortopulmonary window (APW) is a rare congenital heart anomaly. A total of 8 cases with APW confirmed by echocardiography and surgery were retrospectively reviewed and the echocardiographic features analyzed. Among the 8 APW cases, 5 were type II and 3 were type III, the latter of which includes 2 cases complicated with Berry syndrome. Prenatal echocardiography can provide accurate information for the diagnosis of fetal APW. The prognosis depends on the timing of surgery and the nature of the associated cardiac anomalies.
Asunto(s)
Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Ecocardiografía/métodos , Ultrasonografía Prenatal/métodos , Adulto , Aorta/anomalías , Aorta/diagnóstico por imagen , Femenino , Humanos , Embarazo , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto JovenRESUMEN
Aortopulmonary window (APW), the presence of a communication between aorta and pulmonary artery, is a rare congenital heart disease, and surgical intervention is the standard for closure. Recently, several cases have been treated with transcatheter device occluders. Here, we report an APW patient treated successfully using a transcatheter closure with a symmetrical membranous ventricular septal occluder. We are the first to report on a case treated with this type of occluder for APW.