A Rare Case with Dissection of Pulmonary and Aorta in Aortopulmonary Window

Ahmad Amin; Mozhgan Parsaee; Homa Ghaderian; Fatemeh Zohrian; Arezoo Mohamadifar

doi:10.18502/crcp.v7i4.11599

Ahmad Amin Department of Heart Failure and Transplantation, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Mozhgan Parsaee Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Homa Ghaderian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh Zohrian Alborz University of Medical Sciences, Karaj, Alborz, Iran.
Arezoo Mohamadifar Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Massih Daneshvari Educational and Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/crcp.v7i4.11599

Keywords: Aortopulmonary window; Dissection; Congenital heart disease

Abstract

Aortopulmonary window is a rare congenital anomaly which is commonly associated with other lesions such as patent ductus arteriosus, interrupted aortic arch, Atrial Septal Defect (ASD), and Ventricular Septal Defect (VSD). Aortic aneurysm and dissection have not been reported as an associated anomaly in AP window. A 44 -year-old male, with inoperable AortoPulmonary Window (AP window) and Eisenmenger syndrome presented to our Emergency Department with back pain and shortness of breath. Transthoracic echocardiography and aortic CT angiography depicted aneurysmal dilatation of ascending aorta with a dissection flap which was extended to main pulmonary artery. Any intervention was very high risk, due to the risk of imminent RV failure. The patient was hemodynamically stable and the symptoms seemed to be chronic, so we decided to manage him medically. AP window is a rare congenital anomaly which is commonly associated with other anomalies. In this report, we represent a rare case of AP window and Eisenmenger syndrome with aortic aneurysm and dissecting flap in ascending aorta and pulmonary artery who was managed medically.