Aortopulmonary Window

The malfunction of the heart in which a hole is formed due to a disconnection between two blood vessels. This is known as APW or aortopulmonary window. When the connection between the largest artery and the pulmonary arteries gets disrupted and the pattern of the blood flow gets diverted from the normal circulatory system, it is called left-to-right shunt.

This causes a hole between these blood arteries. Aorta carries blood enriched with oxygen from the heart to the body, whereas, pulmonary artery carries less concentration of oxygen in the blood from heart to the lungs. This APW is uncommon, and it is an innate heart defect that is found less than 0.1% of infants.

Types of Aortopulmonary Window

It is categorized into three types on basis of their location, which are mentioned below:

• Type A- Proximal Defects: This defect is situated in the largest artery, which is above the sinus of Valsalva. These can be seen in the form of round, large, and in a big shape.
• Type B- Distal Defects: During development, abnormal movement of the aortic arch causes distal defects. These are small in size and uncommon. This is present in the upper portion of the first part of the aortopulmonary septum
• Type C: It is a combination of type A & B defects, which are of large type. This defect occurs from the first part of the aorta of the right pulmonary artery.

Symptoms Aortopulmonary Window

You can see some signs or symptoms of Aortopulmonary Window in your infants. These are as follows:

• Shortness of breath or dyspnea
• Pneumonia
• Irritability
• Poor eating
• Respiratory infection
• Fast heart rate
• Delayed growth rate
• Breathing problem, like chest wall retraction

Causes of Aortopulmonary Window

The main cause of the aortopulmonary window is not not clearly known yet, however, it may be linked with abnormal fetal growth. This means it has occurred since birth which prevents the separation working of pulmonary artery and aorta.

Diagnosis and Tests

If it is found that your baby has symptoms of an aortopulmonary window, then you should immediately contact a cardiologist. The doctor will run some essential tests to diagnose this heart defect. These are as follows:

• MRI: To get a clear picture of the heart, radio and magnetic waves are used.
• Heart Catheterization: A plastic catheter is used to detect the function of the heart.
• Chest X-Ray: The clear image of the heart can be seen by using radiation of X-Rays. This will help to diagnose APW in small children.
• Echocardiogram: Children who are diagnosed with heart problems should undergo this test. This helps to detect anomalies and the aortopulmonary window in infants.

Treatment For Aortopulmonary Window

The treatment for aortopulmonary window involves the procedure to close that hole through surgery, which involves the following steps:

• All pre-tests are run on newborn babies to get details of APW and its severity.
• This surgery has to be performed as soon as possible after getting diagnosed with APW.
• A general sedative is given to the baby.
• A small cut is made by the surgeon to open the aorta, and a patch is used to close the hole between pulmonary artery and aorta. The pericardium, which is a fibrous sac, is used to fill that gap or hole in the heart.

Note: This surgery is performed in the first year of newborn.

Are There Any Possible Complications With This Treatment?

Yes, there may be some complications, if the aortopulmonary window does not get treated in time. There may be some consequences, such as hypertension in the pulmonary arteries, chronic conditions, like the heart does not pump blood well and can even cause death also.