An aortopulmonary window (APW) is a congenital heart defect that allows for blood to shunt from the aorta into the pulmonary artery, due to an opening between the two. Though sometimes this opening between the two great arteries is very small, many times it is fairly large, which means a greater volume of blood floods the pulmonary artery. This extra blood is a serious problem because it can permanently damage the lungs. Due to this potential, this condition is usually surgically addressed when it is found, which is typically in the first few days or months of life.
This congenital heart defect, like many others, doesn’t necessarily have an identifiable cause. Heart defects can occur for many reasons, including maternal drug use. Most often, people who have a child with a heart defect of any kind have been healthy and responsible during pregnancy and have no family history of heart defects. Sometimes, a child with aortopulmonary window have other defects too, such Tetralogy of Fallot, or the condition may present by itself.
In the first few weeks of life, aortopulmonary window might be missed if it is relatively small. Still, it produces a pronounced murmur that is usually caught during well baby checks. Extremely pronounced aortopulmonary window might be detected in the first few days of life because of this murmur or due to factors like heart failure.
Once the condition is suspected, parents and baby would be referred to a pediatric cardiologist. In addition to a physical exam, the condition might be diagnosed through echocardiogram, electrocardiogram (EKG), and possibly through cardiac catheterization. Catheterization might especially be necessary if the child with this condition is older, because it can be used to scan for pulmonary hypertension and assess its severity.
The biggest concern with a delayed diagnosis is that the lungs will be damaged. This might make a repair more challenging and have a profound effect on quality of life. It is certainly in the child’s best interest for early diagnosis to occur. Life quality is also potentially impacted if other complex defects are present, which might necessitate several surgical repairs. Even in these instances though, many kids do very well.
The main treatment for aortopulmonary window is surgical patching and repair of the two arteries or valves so that they no longer communicate with each other. This is an open-heart surgery and a fairly common one in the world of cardiothoracic surgery. All such surgeries are naturally alarming to parents, but this particular one offers excellent survival rates. Moreover, children who have had this surgery and do not have lung damage are usually fully cured. Although there is occasionally the need to redo the repair, most kids live a happy and normal life without this.
