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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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Last updated: August 5, 2025