Closure of the Aortopulmonary Window

What is Aortopulmonary Window?

  • Aortopulmonary window is an abnormal connection between the two great arteries coming out from the heart, the aorta– from the left ventricle, and the pulmonary artery from the right ventricle.  This communication is often very large and transmits the high pressure from the aorta directly to the lung vessels.  

 

Why does this defect need to be closed quickly? 

  • The communication diverts a large amount of blood from the aorta that is meant to supply the body to the lungs.  This results in flooding of the lungs and excessive pressure in the lung vessels.  The child is unable to cope with this thus resulting in life threatening heart failure that often manifests early in life.  

  • In rare instances the child may survive the heart failure but at the cost of permanent damage to the lung vessels and irreversible elevation of the lung pressures (pulmonary vascular disease).  Correction during early infancy largely prevents these adverse consequences.

 

How can it be closed? 

  • The vast majority of AP windows need surgery because the defects are large and babies are small.  Rarely, when the defect is small, catheter closure with a device may be possible. If the defect is closed at an early age the child often does very well. Long term complications are relatively uncommon.