Abstract
BackgroundAorto-left ventricular tunnel (ALVT) is a rare congenital extracardiac channel that connects the ascending aorta to the left ventricle. To our knowledge, no case has been thus far reported as ALVT with both anomalous origin of right coronary artery (AORCA) and bicuspid aortic valve (BAV).Case presentationWe reported a case of a 5-year-old female diagnosed as ALVT with accompanying AORCA and BAV which had been previously misdiagnosed as aortic regurgitation (AR) triggered by BAV. Additionally, a special modality of ALVT was confirmed in this case during the surgery in which the tunnel was formed by the separation between the roots of two aortic leaflets during the diastolic period.ConclusionsALVT with both AORCA and BAV is clinically uncommon and the aberrant tunnel in ALVT can be formed by the gap between the roots of two aortic leaflets. Besides, ALVT with BAV might easily lead to an inaccurate diagnose as aortic regurgitation caused by BAV. Cardiac surgeons should be alerted for differential diagnosis of ALVT with BAV and isolated bicuspid aortic valve (BAV) causing aortic regurgitation (AR).
Highlights
Aorto-left ventricular tunnel (ALVT) is a rare congenital extracardiac channel that connects the ascending aorta to the left ventricle
ALVT with both anomalous origin of right coronary artery (AORCA) and bicuspid aortic valve (BAV) is clinically uncommon and the aberrant tunnel in ALVT can be formed by the gap between the roots of two aortic leaflets
ALVT with BAV might lead to an inaccurate diagnose as aortic regurgitation caused by BAV
Summary
ALVT is a rare congenital cardiac malformation with a reported incidence of less than 0.1–0.5% [1,2,3]. No case has been so far reported as ALVT with both AORCA and BAV In this case, the tunnel is formed by the gap between the aortic valve leaflets and the aortic wall. ALVT with BAV, which is clinically uncommon, might lead to an inaccurate diagnose as common AR caused by BAV. This misdiagnosis could result in the false clinical decision, delayed treatment and aggravated heart function. Author details 1Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324. West Wenhua Road, Jinan, Shandong 250012, People’s Republic of China. Author details 1Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Shandong 250021, People’s Republic of China. 2School of Medicine, Shandong University, No. West Wenhua Road, Jinan, Shandong 250012, People’s Republic of China. 3Department of Vascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Shandong 250021, People’s Republic of China
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