Ecbocardiographyic diagnosis of aortico-left ventricular tunnel

Abstract

Objective To analyze the echocardiographic features of patients with aortico-left ventricular tunnel (ALVT) and explore the value of echocardiography in the diagnosis of ALVT. Methods Echocardiographic features of 23 patients with ALVT who were admitted to Fuwai Hospital from July 2002 to February 2019 were reviewed and analyzed. The accuracy of echocardiographic diagnosis of ALVT was investigated by comparing the results of echocardiographic diagnosis with intraoperative and cardiac catheterization and CT. The diagnosis methodology was summarized. The reasons for misdiagnosis by echocardiography were analyzed. Results Among the 23 patients with ALVT, 1 case was diagnosed through CT examination prior to the operation and died from the cardiac arrest, 1 case was diagnosed through cardiac catheterization and ventriculography, the remaining 21 patients (91.3%) received the surgical operation and were diagnosed as ALVT. Eighteen patients (78.2%) were accurately diagnosed by echocardiography. One case was misdiagnosed as aortic valve insufficiency, one case was diagnosed as aortic bicuspid valve and regurgitation, two cases misdiagnosed as aortic valve dysplasia and insufficiency, and one case was misdiagnosed as aortic dissection. According to Hovaguimian classification: 8 cases (34.8%) were of type Ⅰ, 12 cases (52.2%) of type Ⅱ, 1 case (4.3%) of type Ⅲ, and 2 cases (8.7%) of type Ⅳ.Different types of patients are treated with different surgical methods. Conclusions ALVT can be accurately diagnosed with echocardiography, but it needs to be differentiated from other aorta to left ventricular shunt or reflux diseases. The establishment of the optimal diagnosis process is helpful to avoid and reduce the missed diagnosis and misdiagnosis to the greatest extent, and provides a reliable basis for the selection of surgical methods. Key words: Echocardiography; Aortico-left ventricular tunnel; Congenital