Transcatheter Closure of Native and Residual Aortopulmonary Window (APW) in Four Children

Background: PW is a defect between the ascending aorta and the pulmonary artery. APW is a defect between the ascending aorta and the pulmonary artery. The standard treatment for this disease is surgery. About 10% of APWs are suitable for percutaneous catheter closure. Materials & Methods: Here we present 4 patients whose APW was transcatheter closed. The first is a 9-month-old infant who was referred to our center with PDA diagnosis. In echocardiography, in addition to PDA, it had a 5 mm APW. In CT Angio, the APW distance from the left coronary artery was adequate and the upper and lower rims were adequate. The defect was closed with a membranous VSD occluder asymmetric size 6. The second case is a 22-month-old infant who underwent VSD and APW surgical repair at the age of 13 months. The patient had residual APW with half systemic PAP. In this patient also residual APW was closed with membranous VSD occluder asymmetric size 6. The third case is an 8-year-old girl whose APW was closed with a muscular VSD occluder size 8 and no residual APW was reported in follow-up. The fourth case is an 8-month-old girl who was diagnosed with PDA and APW at 4 months of age. The patient s PDA was closed at 5 months with the device. The patient s APW was closed with a muscular VSD occluder size 10 but after the device was released, the left coronary artery was obstructed. The patient developed cardiorespiratory arrest, the device was immediately removed by surgery and surgical repair of the defect was performed. All patients were discharged with aspirin and plavix. Results: In all 4 patients APW was closed with VSD occluder, three of which were successful. The smallest patient was 8 months weighing 6 kg and the largest patient was 8 years weighing 21 kg. Conclusions: Most cases of APWs are treated surgically. APWs with adequate upper and lower rim (Type 4) and sufficient distance from the left coronary artery can be closed by the intervention.

کلیدواژه ها:

Aortopulmonary window ، transcatheter ، occluder ، Catheterization