Total anomalous pulmonary venous connection masking an aortopulmonary window: A rare combination of defects

CT Assessment of Aortopulmonary Septal Defect: How to Approach It?

An aortopulmonary septal defect or aortopulmonary window (APW) is a rare cardiovascular anomaly with direct communication between the ascending aorta and the main pulmonary artery leading to a left-to-right shunt. It is accompanied by other cardiovascular anomalies in approximately half of patients. In order to avoid irreversible sequelae, interventional or surgical treatment should be performed as soon as possible. Cardiovascular CT, as a fast, non-invasive technique with excellent spatial resolution, has an increasing role in the evaluation of patients with APW, enabling precise and detailed planning of surgical treatment of APW and associated anomalies if present. This article aims to review the anatomical and clinical features of aortopulmonary septal defect with special emphasis on its detection and characterization by a CT examination.

Total Anomalous Pulmonary Venous Connection and Aortopulmonary Window: Successful Management of a Rare Association

The association of total anomalous pulmonary venous connection (TAPVC) with aortopulmonary window (APW) is extremely rare. The coexistence of these two anomalies will have implications on clinical presentation, diagnosis, and pathophysiology. The lungs are exposed to pulmonary venous hypertension due to obstructed TAPVC as well as pulmonary arterial hypertension due to unrestrictive APW. We describe successful management of this unusual association in a three-month-old child.