Diagnosis and surgical treatment of aortopulmonary fenestration.

A ORTOPUIiMONARY FENESTRATION or partial persistent truncus arteriosus is undoubtedly not as rare a congtenital lesion as earlier statistics have suggested. This defeet is also called aortic septal defect or aortopulmonary winidow. In 1949 Perelman and Putscharl were ab)le to assemble only 14 cases from the literature. Skall-Jensen2 reported 64 additioiial patients collected between 1949 and 1956 inclusive. Tin only 10 of these had the diagnosis been definitely established prior to operationi or death. In 1948 Gross3 achieved the first successful closure of an aortopulmonary fenestration by means of a tape ligature, a mnethod which he himself considered hazardous and uncertain. In 1953 Scott and Sabiston4 reported successful division and suture of this lesion in a 10month-old infant with a clamp technic. Fletcher and associates5 added a third successful case in 1954 performed in a similar manner. Cooley et al.6 advanced the surgical treatnient of this condition with a description in 1957 of three successfully managed cases, onie performed under hypothermia and two under cardiopulmonary bypass. At that presentation, 16 surgical cases were mentioned with nine complete closures, three incomplete closures, and four operative deaths. Skall-Jensen2 in his review added three more completely successful surgical cases, two partially successful ones and three operative deaths. Baronofsky et al.7 recently reported an unusual ease with two congenital aortopulmonary septal defects, 1 cm. and 3 cm. in