Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-02T19:48:30.286Z Has data issue: false hasContentIssue false
  • English
  • Français

The morphology of aortopulmonary windows with regard to their classification and morphogenesis

Published online by Cambridge University Press:  19 August 2008

Siew Yen Ho ,
Leon M. Gerlis ,
Christine Anderson ,
William A. Devine  and
Audrey Smith
Siew Yen Ho*
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
Leon M. Gerlis
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
Christine Anderson
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
William A. Devine
Affiliation:
Department of Pathology, children's Hospital, Pittsburgh
Audrey Smith
Affiliation:
, Department of Anatomy, Institute of Child Health Alder Hey, Liverpool
*
Dr. Siew Yen Ho, Department of Paediatrics, National Heart & Lung Institute, Dovehouse Street, London SW3 6LY, United Kingdom.
Get access Rights & Permissions [Opens in a new window]

Abstract

We examined 25 heart specimens with aortopulmonary windows in order to review the variety of the lesion and its associated malformations. Unlike common arterial trunk, the aortopulmonary window involves a deficiency of the wall of the ascending aorta and that of the pulmonary trunk. The window was in proximal position in three specimens, intermediate position in three specimens, distal position in 16 specimens and was confluent in three specimens. The size of the window varied from 27 to 100% of the total length of the pulmonary trunk but size did not bear any apparent relationship to the position of the defect. The shape of the window was tunnel-like in one case. Of the 16 specimens with distal windows, the orifice of the right pulmonary artery arose from the aorta in seven specimens and was overriding the plane of the window in one specimen. The window occurred as an isolated lesion in four specimens. It was associated with interruption of the aortic arch at the isthmus in eight specimens and between the left carotid and left subclavian arteries in three specimens. A further three specimens had isthmal stenosis. Among the other associated defects were complete transposition (two specimens), tetralogy of Fallot (one specimen), and double outlet right ventricle (one specimen). A ventricular septal defect was present in six of the 25 specimens. The associated lesions found with aortopulmonary window are seldom encountered with common arterial trunk, suggesting these two arterial lesions have different pathogenesis and are not variants of the same entity.

Keywords

Aortopulmonary windowcongenital heart defectinterruption of the aortic arch
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 2 , April 1994 , pp. 146 - 155
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kirby, ML, Gale, TF, Stewart, Neural crest cells contribute to aorticopulmonary septation. Science 1983; 220: 1059–1061.CrossRefGoogle ScholarPubMed
2.Van Mierop, LH, Kutsche, LM. Cardiovascular anomalies in DiGeorge syndrome and importance of neural crest as a possible pathogenetic factor. Am J Cardiol 1986; 58: 133–137.CrossRefGoogle ScholarPubMed
3.Kirby, ML. Cardiac morphogenesis—recent research advances. Pediatr Res 1987; 21: 219–224.CrossRefGoogle ScholarPubMed
4.Nakamura, H, Sumida, H. Neural crest cells and cardiac truncal septation. In: Clark, EB, Takao, A (eds). Developmental Cardiology: Morphogenesis and Function. Futura Publishing Co. Inc., Mount Kisco, NY, 1990, pp 137–146.Google Scholar
5.Mori, K, Ando, M, Takao, A, Ishikawa, S, Imai, Y. Distal type of aorto-pulmonary window. Report of four cases. Br Heart J 1978; 40: 681–689.CrossRefGoogle Scholar
6.Collet, RW, Edwards, JE. Persistent truncus arteriosus: A classification according to anatomic types. J Clin North Am 1949; 29: 1245–1270.CrossRefGoogle Scholar
7.Baronofsky, ID, Gordon, AJ, Grishman, A, Steinfeld, L, Kreel, I. Aortico-pulmonary septal defect. Diagnosis and report of case successfully treated. Am J Cardiol 1960; 5: 273–276.CrossRefGoogle Scholar
8.Meisner, H, Schmidt-Habelmann, P., Sebening, F, Klinner, W. Surgical correction of aorto-pulmonary septal defects. Dis Chest 1968; 53: 750–758.CrossRefGoogle ScholarPubMed
9.Richardson, JV, Doty, DB, Rossi, NP, Ehrenhaft, J. The spectrum of anomalies of aortopulmonary septation. J Thorac Cardiovasc Surg 1979; 78: 21–27.CrossRefGoogle ScholarPubMed
10.Goor, DA, Lillehei, CW. Congenital Malformations of the Heart. Grune and Stratton, New York, London, 1975, pp 166–167.Google Scholar
11.Berry, TE, Bharati, S., Muster, AJ, Idriss, FS, Santucci, B, Lev, M,Paul, MH. Distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and hypoplasia of the aortic isthmus: a newly recognized syndrome. Am J Cardiol 1982; 49: 108–116.CrossRefGoogle ScholarPubMed
12.Clark, CP, Richardson, JP. The management of aortopulmonary window. Advantages of transaortic closure with a Dacron patch. J Thor Card Surg 1976; 72: 48–51.Google Scholar
13.Cook, AC, Groves, A, Ho, SY, Fagg, N, Sharland, G, Anderson, RH, Allan, LD. Aortico-left ventricular tunnel in fetal life. [Submited]Google Scholar
14.Kutsche, LM, Van Mierop, LHS. Anatomy and pathogenesis of aorticopulmonary septal defect. Am J Cardiol 1987; 59: 443–447.CrossRefGoogle ScholarPubMed
15.Bartelings, MM, Gittenberger-deGroot, AC. The outflow tract of the heart. Embryologic and morphologic correlations. Int J Cardiol 1989; 22: 289–300.CrossRefGoogle ScholarPubMed
16.Braunlin, E, Peoples, WM, Freedom, RM, Fyler, DC, Goldblatt, A, Edwards, JE. Interruption of the aortic arch with aorticopulmonary septal defect. Ped Cardiol 1982; 3: 329–335.CrossRefGoogle ScholarPubMed
17.Becu, LM, Tauxe, WN, DuShane, JW, Edwards, JE. A complex of congenital cardiac anomalies: ventricular septal defect, biventricular origin of the pulmonary trunk, and subaortic stenosis. Am Heart J 1955; 50; 901–911.CrossRefGoogle ScholarPubMed
18.Van Praagh, R, Van Praagh, S. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications. Am J Cardiol 1965; 16: 406–425.CrossRefGoogle ScholarPubMed
19.Crupi, G, Macartney, FJ, Anderson, RH. Persistent truncus arteriosus: a study of 66 autopsy cases with special reference to definition and morphogenesis. Am J Cardiol 1977; 40: 569–578.CrossRefGoogle ScholarPubMed
20.Redington, AN, Rigby, ML, Ho, SY, Gunthard, J, Anderson, RH. Aortic atresia with aortopulmonary window and interruption of the aortic arch. Ped Cardiol 1991; 12: 49–51.CrossRefGoogle ScholarPubMed
21.Gerlis, LM, Dickinson, DF, Wilson, N, Gibbs, JL. Persistent fifth aortic arch. A report of two new cases and a review of the literature. IntJ Cardiol 1987; 16: 185–192.CrossRefGoogle Scholar