A Rare Case of Adult Aortopulmonary Window With Eisenmengerization Complicated by Severe Aortic Stenosis and Ortner Syndrome

Aortopulmonary window (APW) is a rare congenital cardiac condition resulting in a communication between the aorta and the pulmonary artery. APW can occur as a single lesion or may be associated with other cardiac defects such as ventricular septal defects, atrial septal defects, and tetralogy of Fallot. More than 50% of APW cases are associated with other additional congenital cardiac defects that require surgery. Most patients can develop congestive heart failure at an early age due to left-to-right shunts. The patient survival rate with untreated APW is very low, with a mortality rate of 40% in the first year. Survival into adulthood without treatment is very uncommon. We herein describe a 62-year-old man with Eisenmengerized APW with acquired severe aortic stenosis, mild pulmonary valvular stenosis, and Ortner syndrome without surgery. Ortner syndrome is mainly caused by the compression of the recurrent laryngeal nerve due to the dilatation of the pulmonary artery and the aorta. (Iranian Heart Journal 2022; 23(3): 114-119).