Aortopulmonary Window or Patent Ductus Arteriosus? The Window Ductus.

The ductal malformation known as a "Window Ductus" or "type B ductus" is a very rare congenital anomaly. The unique anatomy results in a diagnostic and surgical dilemma. It can easily be mistaken for a "typical" patent ductus arteriosus and approached via left thoracotomy. This can potentially result in a surgical misadventure. We report a patient diagnosed with a Window Ductus at 2 months of age with recurrent upper respiratory tract infections and complete left lung collapse. Repair was performed through a median sternotomy on cardiopulmonary bypass. The Window Ductus was clamped only on the aortic side and divided, the aortic cuff was closed primarily, and the resultant opening in the pulmonary artery was patched with autologous pericardium. The patient had a successful repair and complete reexpansion of the left lung over time. Advanced cross-sectional imaging (CT scan) provides the best views for planning the surgical approach for a Window Ductus. Median sternotomy with cardiopulmonary bypass allows a safe and reproducible repair.