Postoperative pulmonary hypertensive crises and right-sided heart failure remain the predominant cause of death in patients undergoing septation of the aortopulmonary window with moderate-to-severe pulmonary arterial hypertension (PAH).1'2 Although a unidirectional, fenestrated valved patch has been used in the setting of hypertensive atrial and ventricular septal defects to decompress the right-sided chambers in the event of pulmonary hypertensive crisis, there is no published report of aortopulmonary septation using this technique so far.3'4 We report the technique and results in 7 patients with a large aortopulmonary window with severe PAH using a fenestrated, unidirectional, valved polytetrafluoroethylene patch.
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