Congenital aortopulumonary window: diagnosis, surgical technique and long-term results

Details

Serval ID
serval:BIB_515F131049E9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Congenital aortopulumonary window: diagnosis, surgical technique and long-term results
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Tkebuchava  T., von Segesser  L. K., Vogt  P. R., Bauersfeld  U., Jenni  R., Kunzli  A., Lachat  M., Turina  M.
ISSN
1010-7940
Publication state
Published
Issued date
02/1997
Peer-reviewed
Oui
Volume
11
Number
2
Pages
293-7
Notes
Journal Article --- Old month value: Feb
Abstract
OBJECTIVE: Congenital aortopulmonary window is rare, often associated with other cardiac anomalies. Surgical repair as the only treatment should be performed before pulmonary vascular changes have developed. This study presents the long-term outcome after surgical correction for this condition. MATERIALS AND METHODS: Between 1971 and 1993, 13 patients with congenital aortopulmonary window were found. 10 had type I, 2 type II and 1 had type III. Concomitant cardiac anomalies were present in 10/13. Eleven patients were operated on at a mean age of 31.2 +/- 48.3 months (range 6 days-10 years). Thoracotomy was used in 3 and sternotomy in 9 patients. In 4/11, the aorto-pulmonary window was simply ligated, 4 had a transpulmonary approach and 1 combined with a transaortic approach. The aortopulmonary window was closed directly in 2 and with a Dacron patch in 1. Cardiopulmonary bypass was used in 6 patients. Associated anomalies in 10/11 patients. RESULTS: There was one operative death (9%): a six-day old boy with interrupted aortic arch died 6 h postoperatively due to low-cardiac output. The mean follow-up period is 8.1 +/- 7.3 years (range 2-24 years). Clinical examination, transaortic echocardiography and/or cardiac catheterization were obtained in the follow-up. There was no late death. All are in New York Heart Association (NYHA) class I. One had to be reoperated on for a recurrent shunt 29 months after ligation and one had angioplasty after 23 months for residual stenosis of the reimplanted right pulmonary artery. The actuarial survival rate is 90% after 1, 5 and 10 years. CONCLUSIONS: The surgical treatment of aortopulmonary window has a low risk, even if associated with major cardiac anomalies. Prompt operative treatment achieves excellent long-term results.
Keywords
Actuarial Analysis Aortopulmonary Septal Defect/classification/mortality/*surgery Child Child, Preschool Exercise Test Female Follow-Up Studies Heart Defects, Congenital/classification/mortality/surgery Hemodynamics/physiology Humans Infant Infant, Newborn Male Postoperative Complications/classification/mortality/surgery Reoperation Survival Rate
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2008 14:18
Last modification date
20/08/2019 14:07
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