Congenital aortopulmonary window; an unusual cause of breathlessness

Having recently moved to the UK, a 27-year-old woman with known uncorrected congenital heart disease was referred for cardiovascular MRI (CMRI) due to increased shortness of breath. CMRI revealed a large (40 mm) aortopulmonary window (figure 1) with complete mixing of the pulmonary and systemic circulations (SaO2 73%), moderate mixed aortic valve disease and mild-moderate pulmonary valve regurgitation. Left and right ventricular …