Aortopulmonary Window

ByLee B. Beerman, MD, Children's Hospital of Pittsburgh of the University of Pittsburgh School of Medicine
Reviewed/Revised Apr 2023
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Aortopulmonary window is an abnormal connection between the aorta and the main pulmonary artery.

  • Symptoms are those of a left-to-right shunt, which include signs of heart failure, such as rapid breathing, poor feeding, and sweating.

  • Diagnosis is by physical examination findings, electrocardiography (ECG), and imaging of the heart.

  • Treatment is with surgical repair.

(See also Overview of Heart Defects.)

Aortopulmonary window is an abnormal opening between the aorta and the main pulmonary artery, which allows blood from the aorta to flow directly into the lungs. The defect results when the single, large blood vessel that exits the heart during fetal development fails to separate completely into the pulmonary artery and the aorta. This abnormality is very rare. Aortopulmonary window can occur on its own or occur with other heart defects, such as atrial septal defect, coarctation of the aorta, or tetralogy of Fallot.

In children with aortopulmonary window, blood flows quickly and forcefully into the lungs, leading to high blood pressure in the lungs (pulmonary hypertension) and heart failure. Eventually, if the defect is not repaired, Eisenmenger syndrome develops.

Symptoms of Aortopulmonary Window

Symptoms are those of a left-to-right shunt. Large left-to-right shunts cause too much blood to flow to the lungs and too much blood to return to the left ventricle, which may lead to signs of heart failure (for example, rapid breathing, poor feeding, easy tiring, excessive sweating). During infancy, these symptoms may result in failure to thrive. A large left-to-right shunt also eventually leads to high blood pressure in lung arteries (pulmonary hypertension). Most infants with an aortopulmonary window have a heart murmur.

Affected infants may have recurring respiratory infections.

Diagnosis of Aortopulmonary Window

  • ECG

  • Chest x-rays

  • Echocardiography (ultrasonography of the heart)

Doctors use the results of a thorough physical examination and electrocardiography (ECG), chest x-rays, and echocardiography to diagnose aortopulmonary window.

Treatment of Aortopulmonary Window

  • Surgical repair

Surgical repair of aortopulmonary window should be done as soon as possible after diagnosis.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  1. American Heart Association: Common Heart Defects: Provides overview of common congenital heart defects for parents and caregivers

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