Aortopulmonary communication between the arterial trunks in tetralogy of Fallot with pulmonary atresia

We reported a case of a 14-year-old tetralogy of Fallot/pulmonary atresia patient, where a rare tubular aortopulmonary communication between the arterial trunks allowed for well-growth of the pulmonary vasculature. The patient underwent successful one-stage unifocalization, right ventricle-pulmonary artery conduit and ventricular septal defect closure. The tubular communication was considered an aortopulmonary window as opposed to the major aortopulmonary collateral, based on its exclusively intrapericardial course. We highlighted the importance of cross-section imaging in diagnosis and surgical decision-making in such situations.