Abstract

Aortico–left ventricular tunnel is a rare congenital anomaly, the incidence of which is estimated to be 1 in 1000 infants born with congenital heart disease. It is characterized by an abnormal, direct, paravalvular, endothelialized communication between the ascending aorta and the left ventricle. Most cases arise upstream of the right coronary sinus, above the sinotubular junction; origin from the left coronary sinus is rare. Patients present with symptoms of congestive heart failure in the first year of life owing to the physiologic effects of the tunnel, which amount to severe para-aortic regurgitation.

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