{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:33:20Z","timestamp":1784374400971,"version":"3.55.0"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>An aortopulmonary septal defect or aortopulmonary window (APW) is a rare cardiovascular anomaly with direct communication between the ascending aorta and the main pulmonary artery leading to a left-to-right shunt. It is accompanied by other cardiovascular anomalies in approximately half of patients. In order to avoid irreversible sequelae, interventional or surgical treatment should be performed as soon as possible. Cardiovascular CT, as a fast, non-invasive technique with excellent spatial resolution, has an increasing role in the evaluation of patients with APW, enabling precise and detailed planning of surgical treatment of APW and associated anomalies if present. This article aims to review the anatomical and clinical features of aortopulmonary septal defect with special emphasis on its detection and characterization by a CT examination.<\/jats:p>","DOI":"10.3390\/jcm13123513","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T06:29:43Z","timestamp":1718605783000},"page":"3513","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["CT Assessment of Aortopulmonary Septal Defect: How to Approach It?"],"prefix":"10.3390","volume":"13","author":[{"given":"Particia","family":"Gu\u017evinec","sequence":"first","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0390-8466","authenticated-orcid":false,"given":"Maja","family":"Hrabak-Paar","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"University Hospital Center Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/S0003-4975(99)01236-9","article-title":"Congenital Heart Surgery Nomenclature and Database Project: Aortopulmonary window","volume":"69","author":"Jacobs","year":"2000","journal-title":"Ann. Thorac. Surg."},{"key":"ref_2","unstructured":"Tatco, V., Murphy, A., Hacking, C., Gower, S., Weerakkody, Y., Rasuli, B., Bell, D.J., Jones, J., Glick, Y., and Edwards, J.E. (2024, June 07). Aortopulmonary Septal Defect. Available online: https:\/\/radiopaedia.org\/articles\/42038."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1148\/rg.301095061","article-title":"Uncommon congenital and acquired aortic diseases: Role of multidetector CT angiography","volume":"30","author":"Zambrana","year":"2010","journal-title":"Radiographics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1159\/000063186","article-title":"Prenatal diagnosis of an aorto-pulmonary window by fetal echocardiography","volume":"17","author":"Collinet","year":"2002","journal-title":"Fetal Diagn. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.pcsu.2011.01.017","article-title":"Aortopulmonary window","volume":"14","author":"Barnes","year":"2011","journal-title":"Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1136\/hrt.40.6.681","article-title":"Distal type of aortopulmonary window. Report of 4 cases","volume":"40","author":"Mori","year":"1978","journal-title":"Br. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/0002-9149(82)90284-3","article-title":"Distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and hypoplasia of the aortic isthmus: A newly recognized syndrome","volume":"49","author":"Berry","year":"1982","journal-title":"Am. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1161\/CIRCULATIONAHA.115.017366","article-title":"Prenatal Diagnosis and Management of Berry Syndrome, a Rare Conotruncal Anatomy","volume":"132","author":"Ghelani","year":"2015","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S1010-7940(96)01048-2","article-title":"Congenital aortopulumonary window: Diagnosis, surgical technique and long-term results","volume":"11","author":"Tkebuchava","year":"1997","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"300060520984656","DOI":"10.1177\/0300060520984656","article-title":"A Rare Case of Adult Aortopulmonary Window Combined with Anomalous Origin of the Right Pulmonary Artery from the Aorta Leading to Eisenmenger Syndrome","volume":"49","author":"Cui","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5606\/tgkdc.dergisi.2018.14772","article-title":"Diagnosis and surgical treatment of aortopulmonary window: Our single-center experience","volume":"26","author":"Yakut","year":"2018","journal-title":"Turk. Gogus Kalp Damar Cerrahisi Derg."},{"key":"ref_12","first-page":"356","article-title":"Aortopulmonary window: A rare congenital heart disease","volume":"97","author":"Costa","year":"2014","journal-title":"JBR-BTR"},{"key":"ref_13","first-page":"e42524","article-title":"Late Identification of a Stealthy Aorto-Pulmonary Window: A Case Report","volume":"15","author":"Belharty","year":"2023","journal-title":"Cureus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jcct.2009.07.003","article-title":"What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT?","volume":"3","author":"Lin","year":"2009","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/RLI.0000000000000601","article-title":"Recent and Upcoming Technological Developments in Computed Tomography: High Speed, Low Dose, Deep Learning, Multienergy","volume":"55","author":"Lell","year":"2020","journal-title":"Invest. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11936-017-0503-0","article-title":"Role of CT in Congenital Heart Disease","volume":"19","author":"Rajiah","year":"2017","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1097\/01.rct.0000181725.07716.f4","article-title":"Three-dimensional computed tomographic imaging of complex congenital cardiovascular abnormalities","volume":"29","author":"Bean","year":"2005","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.1093\/ehjci\/jeac048","article-title":"Radiation safety for cardiovascular computed tomography imaging in paediatric cardiology: A joint expert consensus document of the EACVI, ESCR, AEPC, and ESPR","volume":"23","author":"Francone","year":"2022","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1053\/j.ro.2018.02.003","article-title":"Strategies for Reducing Radiation Dose in CT for Pediatric Patients: How We Do It","volume":"53","author":"Ngo","year":"2018","journal-title":"Semin. Roentgenol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"726","DOI":"10.2214\/AJR.19.22273","article-title":"Optimization of Pediatric Body CT Angiography: What Radiologists Need to Know","volume":"215","author":"Chandra","year":"2020","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_21","unstructured":"(2024, June 07). European Society of Urogenital Radiology Guidelines on Contrast Agents Version 10.0. Available online: http:\/\/www.esur.org\/esur-guidelines-on-contrast-agents\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s00247-022-05526-0","article-title":"Paediatric CT made easy","volume":"53","author":"Nagy","year":"2023","journal-title":"Pediatr. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1148\/rg.2021210105","article-title":"Deep Learning-based Reconstruction for Lower-Dose Pediatric CT: Technical Principles, Image Characteristics, and Clinical Implementations","volume":"41","author":"Nagayama","year":"2021","journal-title":"Radiographics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1093\/ehjci\/jead024","article-title":"Multimodality imaging in thoracic aortic diseases: A clinical consensus statement from the European Association of Cardiovascular Imaging and the European Society of Cardiology working group on aorta and peripheral vascular diseases","volume":"24","author":"Evangelista","year":"2023","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.21037\/cdt.2017.01.12","article-title":"3D printing from cardiovascular CT: A practical guide and review","volume":"7","author":"Otton","year":"2017","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4274\/csmedj.galenos.2023.2023-5-1","article-title":"Aortopulmonary Window: Classification, Associated Cardiac Anomalies, Treatment Options, and Clinical Outcome","volume":"3","author":"Arslan","year":"2023","journal-title":"Cam Sakura Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/icvts\/ivx099","article-title":"Surgical management of aortopulmonary window: 24 years of experience and lessons learned","volume":"25","author":"Gowda","year":"2017","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/ccd.21366","article-title":"Percutaneous closure of nonrestrictive aortopulmonary window in three infants","volume":"71","author":"Trehan","year":"2008","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/2150135119878703","article-title":"Remarkably Still Repairable Large Aortopulmonary Window in an Adult Patient","volume":"11","author":"Zografos","year":"2020","journal-title":"World J. Pediatr. Congenit. Heart Surg."},{"key":"ref_30","first-page":"16","article-title":"A Window to Life: A Rare Association of a Small, Proximal Aortopulmonary Window With Pulmonary Atresia\/Ventricular Septal Defect","volume":"8","author":"Hede","year":"2024","journal-title":"CASE (Phila)"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1542\/peds.76.1.22","article-title":"Cardiovocal syndrome in infancy","volume":"76","author":"Condon","year":"1985","journal-title":"Pediatrics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/j.athoracsur.2014.06.043","article-title":"Outcomes of aortopulmonary window repair in children: 33 years of experience","volume":"98","author":"Naimo","year":"2014","journal-title":"Ann. Thorac. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1111\/echo.14368","article-title":"Aortopulmonary window in adults: A rare entity leading to Eisenmenger syndrome","volume":"36","author":"Tayeh","year":"2019","journal-title":"Echocardiography"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/0002-9149(87)90953-2","article-title":"Anatomy and pathogenesis of aorticopulmonary septal defect","volume":"59","author":"Kutsche","year":"1987","journal-title":"Am. J. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"62","DOI":"10.5152\/eajm.2013.12","article-title":"Interrupted Aortic Arch Associated with AP Window and Complex Cardiac Anomalies: Multi Detector Computed Tomography Findings","volume":"45","author":"Bayraktutan","year":"2013","journal-title":"Eurasian J. Med."},{"key":"ref_36","first-page":"1750","article-title":"Aortopulmonary window: A case diagnosed and surgery confirmed by ultra-fast computed tomography","volume":"117","author":"Zhang","year":"2004","journal-title":"Chin. Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1016\/j.jcct.2018.10.022","article-title":"Tetralogy of fallot with pulmonary atresia and aorto-pulmonary window: Or is it truncus arteriosus?","volume":"14","author":"Rajagopal","year":"2020","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/MS9.0000000000000213","article-title":"Congenital unilateral absence of right pulmonary artery with VSD and wide aortopulmonary window in an adult patient: A case report","volume":"85","author":"Mehta","year":"2023","journal-title":"Ann. Med. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.7863\/ultra.16.08025","article-title":"Prenatal Diagnosis of Aortopulmonary Window: A Case Series and Literature Review","volume":"36","author":"Tongprasert","year":"2017","journal-title":"J. Ultrasound Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1017\/S1047951108002588","article-title":"Lessons learned from a series of patients with missed aortopulmonary windows","volume":"18","author":"Kiran","year":"2008","journal-title":"Cardiol. Young"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3068","DOI":"10.21037\/tp-21-488","article-title":"Prenatal ultrasound diagnosis and management of fetal aortopulmonary septal defects: A case series","volume":"10","author":"Yu","year":"2021","journal-title":"Transl. Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/apc.APC_45_18","article-title":"Total anomalous pulmonary venous connection masking an aortopulmonary window: A rare combination of defects","volume":"11","author":"Samaddar","year":"2018","journal-title":"Ann. Pediatr. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Richardson, R.R. (2017). Imaging Modalities: Advantages and Disadvantages. Atlas of Acquired Cardiovascular Disease Imaging in Children, Springer.","DOI":"10.1007\/978-3-319-44115-3"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Sun, Z. (2023). Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease. Children, 10.","DOI":"10.3390\/children10020319"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/12\/3513\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:59:22Z","timestamp":1760108362000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/12\/3513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,15]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13123513"],"URL":"https:\/\/doi.org\/10.3390\/jcm13123513","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,15]]}}}