Surgical repair of a total-defect aortopulmonary window in a neonate]

Aortopulmonary window (APW) is a rare congenital heart defect that requires urgent repair, as it can lead to rapid development of pulmonary hypertension. A 6-day-old boy with a total-defect APW was transferred to our hospital and underwent definitive repair on the 15th day after birth. The ascending aorta and pulmonary trunk were divided to create a larger tissue margin on the aortic side for the next seam. Then, the aortic window was sutured and closed directly, while the large pulmonary defect was reconstructed with a fresh autologous pericardial patch. Although peritoneal dialysis was briefly required for acute renal failure due to low output syndrome, his condition improved and he was discharged 22 days after surgery. Six years later, he remains well, without complications or need for medication.