Aortopulmonary Window in Adults: Diagnosis and Treatment of Late-presenting Patients
| Autor: | B K P Panicker, V. Ramnath Iyer, Jitendra Mishra, Vijay Sai, Suneil Kumar Aggarwal |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Adolescent Hypertension Pulmonary medicine.medical_treatment Aortopulmonary Septal Defect Aortopulmonary window law.invention Young Adult law Internal medicine medicine Cardiopulmonary bypass Humans Radiology Nuclear Medicine and imaging Cardiac Surgical Procedures Young adult Retrospective Studies Cardiac catheterization New York Heart Association Class I Cardiopulmonary Bypass business.industry Retrospective cohort study General Medicine medicine.disease Surgery Cardiac surgery Treatment Outcome medicine.anatomical_structure Echocardiography Pediatrics Perinatology and Child Health Cardiology Vascular resistance Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Congenital Heart Disease. 3:341-346 |
| ISSN: | 1747-0803 1747-079X |
| DOI: | 10.1111/j.1747-0803.2008.00210.x |
| Popis: | Objectives. Aortopulmonary window is an uncommon condition, particularly so in adulthood because it is usually fatal in infancy or childhood if untreated. Very few cases of those who have survived to adulthood and been operated on successfully have been described. Our study aimed to provide clinical, investigative, surgical, and outcome details of such patients. Design and Setting. Retrospective study of consecutive adult patients with aortopulmonary window treated at a tertiary charitable cardiovascular institute in South India between 1996 and 2006. Results. Six adult patients successfully underwent aortopulmonary window closure. Five of the six patients had been correctly diagnosed on echocardiography, while one was only diagnosed after cardiac catheterization for unexplained pulmonary arterial hypertension. Four of the patients had large defects with severe pulmonary arterial hypertension, with pulmonary vascular resistance index (PVRI) ranging from 5.2 to 15.9 at baseline. All showed significant reversibility with oxygen administration, with PVRI on oxygen falling to between 0.6 and 2.2. These patients successfully underwent cardiopulmonary bypass. The other two patients with small lesions underwent ligation off-pump. There was no early or late mortality among these patients. All were in New York Heart Association class I, on follow-up ranging from 3 months to 8 years. Conclusions. Aortopulmonary window may rarely present in adulthood. The diagnosis can usually be made by careful echocardiography alone. Even in the presence of severe pulmonary arterial hypertension, if a significant reversibility in pulmonary vascular resistance can be demonstrated with oxygen, the condition can be successfully corrected with good long-term outcomes. |
| Databáze: | OpenAIRE |
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