Response by Myers and Beghetti to Letter Regarding Article, “Unrestrictive Aortopulmonary Window: Extreme Presentation as Non-Eisenmenger in a 30-Year-Old Patient”
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We thank Murakami and colleagues for their questions and the opportunity to discuss this very interesting patient.1 As they suggest, the aortopulmonary window was likely hemodynamically restrictive because the pulmonary artery pressure was 40% systemic and both echocardiography and cardiac magnetic resonance imaging showed flow acceleration at the level of the defect. However, the size of the defect was close to that of the aortic annulus, and the pulmonary artery, left atrium, and left ventricle were severely dilated, showing a significant left-to-right shunt that would be expected to result in pulmonary vascular disease …