Aortopulmonary septal defect

Case contributed by Vincent Tatco
Diagnosis certain

Presentation

Murmur on chest auscultation during physical examination.

Patient Data

Age: 20
Gender: Male

CT demonstrates an abnormal communication between the ascending aorta and main pulmonary trunk.  The pulmonary arteries, left ventricle and left atrium are dilated. 

Case Discussion

Aortopulmonary septal defect (APSD), also known as aortopulmonary window (APW), is a cardiac abnormality that results from abnormal communication between the proximal aorta and the main pulmonary artery.  It is an uncommon anomaly, occurring in less than 1% of all persons with a congenital heart disease.  It has similar hemodynamic features to a patent ductus arteriosus, ventricular septal defect, or, even more so, to a common truncus arteriosus, the anatomical difference from the latter being the presence of separate well-defined aortic and pulmonary valves. 

This term should not be confused with the radiologic aortopulmonary window (AP window), which refers to a mediastinal space on chest radiographs and CT scans.

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