Evaluation of aortopulmonary window using virtual dissection of multidetector computed tomography angiography data sets

J Card Surg. 2022 Dec;37(12):4475-4484. doi: 10.1111/jocs.17075. Epub 2022 Nov 2.


Aim: The present study sought to evaluate the morphology and associated cardiovascular anomalies in patients with aortopulmonary window on virtual dissection of multidetector computed tomography (CT) angiography data sets.

Material and methods: We conducted a retrospective search of our departmental database from January 2014 to September 2021 to identify patients with aortopulmonary window and relevant information was extracted from the electronic case records and from routine examination as well as virtual dissection of CT data sets.

Results: An aortopulmonary window was observed in 26 patients (20 males; 6 females). Based on location of the defect, a distal aortopulmonary window was the most common subtype, seen in 13/26 (50%) patients followed by a proximal, complete and intermediate subtypes seen in 7/26 (27%), 5/26 (19%) and 1/26 (4%) patients respectively. Associated ventricular septal defect was observed in 9/26 (34.6%) patients while an interrupted aortic arch was present in 5/26 (19.2%) patients. Tetralogy of Fallot was seen in 5/26 (19.2%) patients. Anomalous origin of right pulmonary artery from ascending aorta and crossed pulmonary arteries were seen in 2/26 (7.6%) patients each. An isolated aortopulmonary window without any simple/complex congenital anomaly was seen in 10/26 (38.5%) patients.

Conclusion: Aortopulmonary window is associated with a wide gamut of cardiovascular lesions, with ventricular septal defect being the commonest associated anomaly followed by tetralogy of Fallot and interrupted aortic arch respectively. Virtual dissection of multidetector CT angiography allows detailed anatomical evaluation of aortopulmonary window, allowing a clear visualization of the defect and associated cardiovascular anomalies.

Keywords: aortopulmonary window; computed tomography angiography; virtual dissection.

MeSH terms

  • Angiography
  • Aortic Coarctation* / surgery
  • Aortopulmonary Septal Defect* / complications
  • Aortopulmonary Septal Defect* / diagnostic imaging
  • Aortopulmonary Septal Defect* / surgery
  • Cardiovascular Abnormalities* / complications
  • Female
  • Heart Septal Defects, Ventricular* / complications
  • Heart Septal Defects, Ventricular* / diagnostic imaging
  • Heart Septal Defects, Ventricular* / surgery
  • Humans
  • Male
  • Multidetector Computed Tomography
  • Pulmonary Artery / surgery
  • Retrospective Studies
  • Tetralogy of Fallot* / complications