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1/54. Aortopulmonary window with anomalous origin of the right coronary artery.

    We report a case of an aortopulmonary window with a right coronary artery arising from the pulmonary trunk. This exceedingly rare anomaly with anomalous coronary artery presented without myocardial ischemia owing to the aortopulmonary window. The correct diagnosis was made by angiography and a successful surgical correction was performed. ( info)

2/54. Transesophageal echocardiography in aortopulmonary communications.

    The assessment of congenital aortopulmonary communications by transthoracic echocardiography may be suboptimal, particularly postoperatively, due to limited acoustic windows. We performed intraoperative transesophageal echocardiograms in six patients with eight proven systemic-pulmonary communications. Diagnosis included truncus arteriosus (1), aortopulmonary window (1), Waterston anastomosis (3), central Gore-Tex shunt (1), and modified left Blalock-Taussig shunt (2). All communications were accurately demonstrated by transesophageal echocardiography (TEE). The transesophageal technique also provided an assessment of the size of the aortopulmonary communications and the proximal pulmonary arteries. In addition, the gradient across some of the communications could be accurately estimated utilizing the high pulse repetition frequency Doppler. On the other hand, only two of the seven aortopulmonary communications were detected by transthoracic echocardiography. Postoperatively, transesophageal imaging demonstrated unobstructed conduit in five of five patients who underwent conduit repair, as well as intact closure of aortopulmonary communications and concomitant closure of ventricular septal defects. ( info)

3/54. As originally published in 1992: new surgical technique for total-defect aortopulmonary window. Updated in 1999.

    A new technique is described to repair aortopulmonary window with total defect in an 8-day-old baby. Because we expected the future growth of aorta, we used the anterior wall of the pulmonary artery as a large flap to reconstruct the posterolateral aortic wall. An equine pericardial patch was used to repair the defect in the pulmonary artery. This is a logically effective method for aortic reconstruction in a neonate with a large aortopulmonary septal defect. ( info)

4/54. tetralogy of fallot with non-confluent pulmonary arteries and aortopulmonary septal defect.

    aortopulmonary septal defect and tetralogy of fallot is a rare combination. We report a case of tetralogy of fallot, non-confluent pulmonary arteries with the left arising from the arterial duct, and a large aortopulmonary septal defect diagnosed by echocardiogram and confirmed by cardiac catheterization. ( info)

5/54. Aortopulmonary window: a case report.

    Aortopulmonary window (A-P window) is a rare congenital heart disease. The majority of patients come to the hospital with congestive heart failure. If they are left untreated, irreversible pulmonary vascular hypertension inevitably occurs. Although the hemodynamic of this disease resembles large persistent ductus arteriosus, the treatment is quite different. We report one patient of A-P window, a 4 month-old girl, who presented with fever and dyspnea. On investigations, she had A-P window. We successfully treated her by closure the defect under cardiopulmonary bypass. We describe the technique we used. ( info)

6/54. AP window and anomalous origin of right coronary artery from the window.

    Aortopulmonary window (APW) is a rare malformation. We recently operated on a child with APW, ventricular septal defect, right aortic arch, and anomalous right coronary artery from the APW. This patient also had a chromosomal abnormality. He underwent the repair of this complex lesion in a staged operation. ( info)

7/54. One-stage repair of interrupted aortic arch and aortopulmonary window with an autologous arterial flap.

    Interrupted aortic arch associated with an aortopulmonary window is a rare congenital malformation that requires an early diagnosis and surgical treatment to avoid irreversible pulmonary vascular changes. We describe herein successful one-stage repair in a neonate without the use of pericardium or other prosthetic material. Use of a transaortic approach permitted both accurate planning of the appropriate size of pulmonary trunk flap and also facilitated easy repair of the aortopulmonary septal defect. The growth potential of both great arteries was optimized. ( info)

8/54. Amplatzer device closure of a residual aortopulmonary window.

    Significant residual defects after surgical closure of aortopulmonary windows have previously required re-operation. In this paper, we describe the use of a custom made Amplatzer closure device to occlude a hemodynamically significant defect in a 5-year-old child. The device was successfully deployed without complication, and resulted in a major reduction in aorto-pulmonary flow. ( info)

9/54. A cross between truncus arteriosus communis and aortopulmonary septal defect: a hitherto undescribed entity.

    Case history and necropsy findings of a 5-month-old infant with a unique heart defect with features of truncus arteriosus communis and aortopulmonary defect in combination with severe tricuspid stenosis are presented. There is a wide spectrum of remarkable heart defects between truncus arteriosus communis and aortopulmonary septal defect. ( info)

10/54. Aortopulmonary window coexisting with tetralogy of fallot.

    Aortopulmonary window is a rare cardiac malformation presenting either in the isolated form, or in association with other cardiac anomalies. The isolated form usually presents an increased pulmonary blood flow as the main clinical feature, but if associated with other cardiac anomalies the clinical findings change according to the additional defect. Only 19 cases of aortopulmonary window associated with tetralogy of fallot have been reported. Five of them have associated pulmonary atresia. We report two neonatal cases of aortopulmonary window and tetralogy of fallot, one of them presenting an associated pulmonary atresia. ( info)
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