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Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP C-182

All Windows Are Not Healthy Windows

By Mahmood Hasan Khan, A. Q. M. Reza

Presenter

Mahmood Hasan Khan

Authors

Mahmood Hasan Khan1, A. Q. M. Reza2

Affiliation

Delta Medical College & Hospital, Dhaka, Bangladesh1, Evercare Hospital Dhaka, Bangladesh2,
View Study Report
TCTAP C-182
STRUCTURAL HEART DISEASE - Congenital Heart Disease (ASD, PDA, PFO, VSD)

All Windows Are Not Healthy Windows

Mahmood Hasan Khan1, A. Q. M. Reza2

Delta Medical College & Hospital, Dhaka, Bangladesh1, Evercare Hospital Dhaka, Bangladesh2,

Clinical Information

Patient initials or Identifier Number

AA, 19 years old female

Relevant Clinical History and Physical Exam

Without any significant co-morbidities

Admitted with the complaints of exertional shortness of 
breath, palpitation for last 06 months

Lean & thin, mildly anemic, acyanotic but with clubbed 
fingers

S1 normal, P2 of S2 is loud

Continuous murmur in the pulmonary area.

Relevant Test Results Prior to Catheterization

ECG:
•NSR
•Rate: 100 beats/min
•Rhythm: Regular
•Tall, peaked p wave indicating RAE
•Small Q in I, aVL, V5 & V6
•Few non-specific ST-T changes

Chest X-ray:

Mild congestion

Echo:

•A large (~23 mm) A-P window with reversal of shunt
•Moderate TR
•Severe PH with PASP: 86 mmHg











Relevant Catheterization Findings

A large AP window with no reversibility was seen.



Interventional Management

Procedural Step

üOximetry showed significant step up from RV to PA

üPVR was 27.69 Wood units before oxygen and 26.88 Wood units 
   after 100% oxygen for 10 minutes.

üPredominant right to left shunt persisted both before and after 
   oxygen.

üThere was no reversibility of PVR observed after 100% oxygen for 
   10 minutes.

üLVgraphy, root aortography & descending aortography were done.

üRoot aortography showed a large aorto-pulmonary window 
   through which contrast passing from aorta to pulmonary trunk

üSo, in one sentence, a large AP window with no reversibility was 
   seen.



Case Summary

•Aorto-Pulmonary window is a rare congenital heart disease.
•The probability of surgical cure will be dependent on the age at operation and level of 
pulmonary vascular resistance.

•APW can be confused with other defects. Clinical findings, associated with an adequate 

echocardiogram can provide the information for the correct diagnosis.