AORTOPULMONARY WINDOW: AN 18 YEARS
EVALUATION OF PATIENTS
Paridokht Nakhostin Davari
Rajaie Heart Hospital, Tehran, Iran
Objective: Aortopulmonary window
(APW) is a rare congenital heart anomaly. During years 1983 to 2001, 25
patients were admitted at this center with this diagnosis to evaluated and
treated.
The reason for choosing this subjects is that many patients were
admitted with a different diagnosis and at hospital APW was discovered,
furthermore existance of different anomalies leads to different surgeries
in the same patient
Methods: The method of research is
retrospective research with collection of all files which were registered
with the code of APW at hospital. As a whole of 25 patients with this
diagnosis 9 (36%) were female and 16 (64%) were male.
The age of admission was between 7 mo and
35 ys, with the median of 5 years, mean 8.3 years and SD of 9 years. Type I
was observed in 22 patients (88%) and type III in 3 (12%). None of them had
type II.
ECG, Chest X-Ray, Echocardiography and catheterization and angiography has been performed for
all of the patients.Other diagnoses by Echo were PDA, AS or different
anomalies like TGV.
15 patients (60%) had systemic PH, 8 (32%)
had subsystemic PH and 2 had normal PA pressure. 8 patients (32%) were in
operable. In 8 (32%) APW closure was performed with dacron or pericardial
patch. 3 (12%) had residual APW in whom reoperation was perfomed later.
Results: The research shows that in
11 patients (44%) surgery has been successful and patients were followed up
as outpatients. 8 (32%) were inoperable and 3 (12%) needed reoperation. 2
deaths has been observed.
Conclusion:
The evaluation shows that increased age disturbs the response to treatment
and patients were inoperable (P<0.02). In addition increased PAP results
in the risk of patients and turns them inoperable (P<018).