Aortopulmonary Window (AP Window)

James M. Meza, MD, Nicholas D. Andersen, MD, Robert D.B. Jaquiss, MD

Key Points

Aortopulmonary window (APW) is defined as a communication between the ascending aorta and pulmonary artery above the level of the two semilunar valves. It is typically a large and unrestrictive defect, which results in a large left-to-right shunt, leading to progressive pulmonary overcirculation and cardiac volume loading. The diagnosis of APW, in and of itself, is an indication for intervention. The most common associated lesion is Type A interrupted aortic arch. For isolated APW, three approaches to repair have been employed: transpulmonary, transaortic, or through the APW itself. Long-term survival is >80% at 10 years.

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