Search

Aims To determine whether TAPSE is an accurate marker of right ventricular (RV) systolic function in patients with tetralogy of Fallot (TOF) and patients with small atrial septal defect (ASD). The tricuspid annular plane systolic excursion (TAPSE) values were measured and compared with RV ejection fraction (EF).

Sirs: The aortopulmonary window (APW) is a rare congenital malformation and represents about 0.2% of congenital heart defects. The presence of two semilunar valves distinguishes this anomaly from persistent truncus arteriosus. It is associated with other cardiac defects in about 50% of the cases [1]. Most common associated defects are interrupted aortic arch or coarctation of the aorta, tetralogy of fallot, ventricular septal defect, and anomalies of the coronary artery [1]. Its variability in morphology is reflected by various classifications, previously reviewed by Jacobs et al. [3], resulting in a current standard nomenclature for APW. Proximal APW like in our case, also described as type I defect, is the most common type and characterized as an APW located few millimeters above the sinus of Valsalva [3]. To date few case reports exist about APW in combination with pulmonary stenosis or atresia and ventricular septal defect [5, 6]. However, to our knowledge our case is the first case of a patient with APW window supporting pulmonary flow in the setting of a critical pulmonary stenosis (PS) in combination with a hypoplastic right ventricle (RV).

Sirs:We would like to comment on the Letter to the Editor byDalla Pozza et al. [1].TOF patients show a broad spectrum of right ventricular(RV) volume overload mainly due to pulmonary regurgi-tation (PR) during the postoperative course. Dalla Pozzaet al. [1] stated that TOF patients with significantly ele-vated indexed RV end-diastolic volume (RVEVDi), e.g.with an RVEDVi[150 ml/m