Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-qpj69 Total loading time: 10.727 Render date: 2021-02-26T02:01:01.097Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Lessons learned from a series of patients with missed aortopulmonary windows

Published online by Cambridge University Press:  21 July 2008

Viralam S. Kiran
Affiliation:
Department of Paediatric Cardiology, Anekal Taluk, Bangalore, Karnataka, India
Mukesh Kumar Singh
Affiliation:
Department of Paediatric Cardiology, Anekal Taluk, Bangalore, Karnataka, India
Sejal Shah
Affiliation:
Department of Paediatric Cardiology, Anekal Taluk, Bangalore, Karnataka, India
Colin John
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Hrudayalaya Institute of Cardiac Sciences, Anekal Taluk, Bangalore, Karnataka, India
Sunita Maheshwari
Affiliation:
Department of Paediatric Cardiology, Anekal Taluk, Bangalore, Karnataka, India
Corresponding

Abstract

Objectives

To identify factors contributing to missed diagnosis of aortopulmonary windows on initial echocardiographic examination; and to analyze lesions associated with these malformations.

Design

Retrospective study where echocardiographic findings and per-operative findings of patients were correlated by reviewing records.

Setting

Tertiary-care paediatric cardiac centre.

Patients

From May 2002 to September 2007, we diagnosed 50 patients with aortopulmonary windows. The group included 31 boys and 19 girls. Mean age at intervention was 1.7 years, with a range from 3 months to 17 years.

Results

The diagnosis of aortopulmonary window was made correctly by echocardiography during initial evaluation in 46 of 50 patients (92%). The remaining 4 patients were diagnosed either during repeat echocardiographic evaluation, cardiac catheterization, or per-operatively. We describe the details of these patients. Of the 50 patients, 23 had associated malformations, including ventricular septal defects in 10 patients, patent arterial ducts in 9, atrial septal defects or patent oval foramens in 5, 3 of whom also had patent arterial ducts, interruption of the aortic arch at the isthmus in 4, or between the left subclavian and common carotid arteries in 2, tetralogy of Fallot in 2, double-outlet right ventricle in 2, discordant ventriculo-arterial connections in 2, 1 of whom also had anomalous origin of the left coronary artery from the pulmonary trunk, and superior-inferior ventricles in 1 patient.

Conclusions

Even meticulous echocardiography may result in a false negative diagnosis of an aortopulmonary window. A high index of suspicion for this lesion is warranted in cases of unexplained severe pulmonary arterial hypertension, and/or unexplained cardiac dilation.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below.

References

1. Kutsche, LM, Van Mierop, LHS. Anatomy and pathogenesis of aortopulmonary septal defect. Am J Cardiol 1987; 59: 443447.CrossRefGoogle Scholar
2. Van Son, JA, Puga, FJ, Danielson, GK, et al. Aortopulmonary septal defect: factors associated with early and late success after surgical treatment. Mayo Clin Proc 1993; 68: 128133.CrossRefGoogle ScholarPubMed
3. Mori, K, Ando, M, Takao, A, Ishikawa, S, Imai, Y. Distal type of aortopulmonary septal defect. Br Heart J 1978; 40: 681689.CrossRefGoogle Scholar
4. Jansen, C, Hruda, J, Rammeloo, L, Ottenkamp, J, Hazekamp, MG. Surgical repair of aortopulmonary septal defect: thirty-seven years of experience. Paediatr Cardiol 2006; 27: 552556.CrossRefGoogle ScholarPubMed
5. Comin, J, Manito, N, Roca, J, Castells, E, Esplugas, E. Insuficiencia mitral funcional. Functional mitral regurgitation. Physiopathology and impact of medical therapy and surgical techniques for left ventricle reduction. Rev Esp Cardiol 1999; 52: 512520.Google Scholar
6. Snider, AR, Serwer, GA, Ritter, SB. Defects in cardiac septation. In: de Young, L, Geistler, JB, Patterson, J (eds). Echocardiography in Paediatric Heart Disease. Mosby Year Book Inc., St Louis, 1997, pp 292293.Google Scholar
7. Balaji, S, Burch, M, Sullivan, ID. Accuracy of cross-sectional echocardiography in diagnosis of aortopulmonary window. Am J Cardiol 1991; 15: 650653.CrossRefGoogle Scholar
8. Prasad, TR, Valiathan, MS, Shyamakrishnan, KG, Venkitachalam, CG. Surgical management of aortopulmonary septal defect. Ann Thorac Surg 1999; 47: 877879.CrossRefGoogle ScholarPubMed
9. Carminati, M, Borghi, A, Valsecchi, O, et al. Aortopulmonary window coexisting with tetralogy of Fallot: echocardiographic diagnosis. Pediatr Cardiol 1990; 11: 4143.CrossRefGoogle ScholarPubMed
10. Tirado, AM, de Soto, JS, Montero, JG, et al. Aortopulmonary window: clinical assessment and surgical results. Rev Esp Cardiol 2002; 55: 266270.Google Scholar
11. Sridhar, PG, Kalyanpur, A, Suresh, PV, Sharma, R, Maheshwari, S. Helical CT evaluation of aortopulmonary septal defect. Ind J Radiol Imag 2006; 16: 847849.CrossRefGoogle Scholar
12. Teo, EL, Goldberg, CS, Strouse, PJ, Vermilion, RP, Bove, EL. Aortopulmonary septal defect with interrupted aortic arch and pulmonary artery sling: diagnosis by echocardiography and magnetic resonance imaging: case report and literature review. Echocardiography 1999; 16: 147150.CrossRefGoogle Scholar
13. Faulkner, SL, Oldham, RR, Atwood, GF, Graham, TP Jr. Aortopulmonary septal defect, ventricular septal defect and membranous pulmonary atresia with a diagnosis of truncus arteriosus. Chest 1974; 65: 351353.CrossRefGoogle ScholarPubMed
14. Bertolini, A, Dalmonte, P, Bava, GL, Moretti, R, Cervo, G, Marasini, M. Aortopulmonary septal defects. A review of the literature and report of ten cases. J Cardiovasc Surg (Torino) 1994; 35: 207213.Google ScholarPubMed

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 2
Total number of PDF views: 24 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 26th February 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Lessons learned from a series of patients with missed aortopulmonary windows
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Lessons learned from a series of patients with missed aortopulmonary windows
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Lessons learned from a series of patients with missed aortopulmonary windows
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *