Aortopulmonary window and interrupted aortic arch in a neonate assessed by 64-slice computed tomography

摘要

A newborn baby, born prematurely at 34 weeks' gestation, had a neonatal diagnosis of aortopulmonary window after respiratory distress at 6 days of life, with a systolic heart murmur. He underwent two-dimensional echocardiography, which depicted an 8 mm defect between the aorta and the pulmonary artery with a massive left-to-right shunt (Fig. 1). Dual-source 64-channel multidetector computed tomography (Definition, Siemens, Forchheim, Germany), with a dose product length of 58 mGy x cm, collimation of 64x0.6 mm (dual-source protocol), kV = 80, mAS = 250 and injection of 1.5mL/kg of iodine contrast (300 mg iodine/mL), was performed to depict associated lesions. A type A IM was found, where interruption occurs beyond the left subclavian artery, with a large ductus arteriosus irrigating the descending aorta (Fig. 2). Pulmonary artery pressure was assessed isosytemically by the low velocity through the window. Successful cardiac surgical repair was performed and consisted of aortic arch repair and direct patch repair of the aortopulmonary window.