Aortico-left Ventricular Tunnel Research Articles

A Case of Aortico-Left Ventricular Tunnel Previously Confused With Right Coronary Cusp Aneurysm

A Case of Aortico-Left Ventricular Tunnel Previously Confused With Right Coronary Cusp Aneurysm

Surgical repair of an aortico-left ventricular tunnel with Takayasu's arteritis

Aortico-left ventricular tunnel is a very rare congenital cardiac anomaly, always arises from the right coronary sinus and enters the left ventricle. However, aortico-left ventricular tunnel associated with Takayasu's arteritis has not been described so far in the literature. Here, we present an unusual case of aortico-left ventricular tunnel associated with Takayasu's arteritis in a 44-year-old man.

Characteristics and long-term outcomes of aortico-left ventricular tunnel.

Aortico-left ventricular tunnel (ALVT) is an extremely rare, abnormal paravalvular communication between the aorta and the left ventricle. Few studies have identified the characteristics and long-term prognosis associated with ALVT. The data of 31 patients with ALVT from July 2002 to December 2019 were reviewed. Echocardiography was performed in all patients during the follow-up period. The median age of the patients was 11.5 years. Bicuspid aortic valve and dilatation of the ascending aorta were found in 13 patients, respectively. The aortic orifice in 20 patients showed a close relation to the right sinus and the right-left commissure. Of the 31 patients, 26 were operated on. Mechanical valve replacement was performed in 4 patients and aortic valve repair, in 6 patients. Ascending aortoplasty was performed in 5 patients and aortic replacement was done in 2 patients. One patient died of ventricular fibrillation before the operation. Follow-up of the remaining 30 patients ranged from 1 to 210 months (median 64 months). There were 4 deaths during the follow-up period: 1 had mechanical valve replacement and 3 did not undergo surgical repair. In the 26 patients without aortic valve replacement, 6 had severe regurgitation and 2 had moderate regurgitation. In the 28 patients without replacement of the ascending aorta, 11 had continued dilatation of the ascending aorta, including those who had aortoplasty. The aortic orifice of ALVT showed an association with the right sinus and the right-left commissure. For patients who did not have surgery, the long-term survival rate remained terrible. Surgical closure should be done as soon as possible after ALVT is diagnosed. The main long-term complications after surgical repair included aortic regurgitation and ascending aortic dilatation.

Ascending Aortic Aneurysm After Repair of Aortico–Left Ventricular Tunnel

Ascending aortic aneurysm following aortico-left ventricular tunnel (ALVT) repair is an uncommon but life-threatening complication. A 27-year-old man had received patch closure for ALVT at infancy. Eighteen years later, aortic valve replacement for severe aortic regurgitation and direct suture for recurrent slit tunnel were performed. Another9years later, ascending aortic replacement was performed because of ascending aortic aneurysm. Thus we report an uncommon case of ascending aortic aneurysm 27years after the repair of an ALVT.

Tunel aortalno-lewokomorowy — rzadka przyczyna szmeru skurczowo-rozkurczowego

Aortico–left ventricular tunnel (ALVT) is a rare congenital paravalvular communication between the aorta and the left ventricle (LV), with few hundred odd cases reported till date. Most commonly the tunnel arises from the right aortic sinus. We herein report a case of AVLT in a 28-year old male where a common pouch, which was communicating to both the left, as well as right aortic sinus, was draining to the left ventricle. He presented with progressive heart failure where a long diastolic murmur was audible. The patient succumbed to death because of progressive cardiac decompensation before surgical correction could have been performed. This is a first ever report of AVLT where proximal chamber as a common sac, communicating with both the left, as well as right aortic sinus, was communicating distally to the left ventricle. Key words- Aortico- left ventricular tunnel, Congenital heart defect, Aortic regurgitation; Diastolic murmur; Cardiac decompensation

Imaging by multislice CT of a large aortico-left ventricular tunnel mimicking as ventricular septal defect

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac anomaly that presents as paravalvular communication connecting the ascending aorta above the sinotubular junction and the left ventricle. In majority of cases the aortic orifice lies above the right coronary sinus (RCS). Clinically, most such cases present along with congestive heart failure. ALVT is associated with many cardiac anomalies like bicuspid aortic valve, patent ductus arteriosus and ventricular septal defect (VSD). Here we describe a case of ALVT that was misinterpreted as VSD initially on echocardiography. This report highlights the significance of multislice CT angiography (CTA) in accurate preoperative diagnosis of this rare entity.

Clinical value of diagnosing aortico-left ventricular tunnel by echocardiography.

In order to assess the clinical value of echocardiography in the diagnosis of aortico-left ventricular tunnel (ALVT) the echocardiographic data and clinical manifestations of six patients with ALVT were analyzed in the present study. Based on the results, a comprehensive study was conducted regarding 147 cases from related documents. Six patients were confirmed with ALVT by surgery. The echocardiographic images of the patients revealed an abnormal communication beginning in the ascending aorta above the coronary arteries, bypassing the aortic valve, and ending in the left ventricle. The color Doppler flow imaging showed a high-speed to- and -fro flow with or without the involvement of the aortic valve. According to Hovaguimian type casting, there were two cases of type I, two cases of type III, one case of type IV, and one case of type II (postoperative recanalization). Of the 153 cases reported, the accuracy rate of the ultrasound diagnosis was 79.6%, the misdiagnosis rate was 17.1%, and the missed diagnostic rate was 3.3%. In conclusion, echocardiography is the preferred method for non-invasive preoperative diagnosis of the ALVT and can accurately describe the type and involvement of the cardiac structure.

Transvalvular Aortico left ventricular tunnel – A rare congenital cardiac anomaly

The aortico-left ventricular tunnel is an abnormal congenital paravalvular communication between the ascending aorta and the cavity of left ventricle. Clinical picture suggests severe aortic incompetence. We report the case of a teenage male patient whose echocardiography revealed a Type III Aortico-left ventricular Tunnel with the aortic end of the tunnel originating through a fenestration in the right coronary cusp, which is not so far reported in literature. The patient had uneventful recovery after surgical patch closure of the tunnel.

Aortico-left ventricular tunnel with uncommon origin

A 33-year old woman presented with moderate dyspnoea on exercise. Transthoracic echocardiogram showed two eccentric jets of severe aortic regurgitation (AR). The left ventricle (LV) was dilated with preserved function (end-diastolic dimension of 58 mm and ejection fraction of 65%). Transoesophageal echocardiogram was performed, and aortico-left ventricular tunnel (ALVT) was seen …

Surgical Repair of an Aortico-Left Ventricular Tunnel with Acute Infective Endocarditis

Aortic-left ventricular tunnel is a rare congenital cardiac anomaly, which always arises from the right coronary sinus and enters the left ventricle, occasionally the right ventricle and right atrium. However, aortic and left ventricular tunnel associated with infective endocarditis is rarely seen in literatures. Here, we present a case of aortic and left ventricular tunnel associated with infective endocarditis in a 47-year-old man.

左室大動脈トンネルに対する新生児期手術の1例

左室大動脈トンネルに対する新生児期手術の1例

Aorto-Left Ventricular Tunnel Arising From the Left Coronary Sinus of Valsalva

Aortico-left ventricular tunnel is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we present a case of Aortico-left ventricular tunnel, in which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid injuring the left coronary artery at the time of surgical repair.

Smart Nature. Aortico‐Left Ventricular Tunnel Bypassing Congenital Critical Aortic Stenosis

Mini‐AbstractThe presented case illustrates a neonate with aortico‐left ventricular tunnel (ALVT) and critical aortic stenosis (AS), who successfully underwent Ross procedure. Case: A neonate presented with critical AS due to a dysplastic aortic valve and an ALVT, consisting of an aneurysmatic, extracardiac component and an aortic insertion of the tunnel just above the right coronary sinus. The child underwent successful Ross operation and resection of the ALVT on 9th day of life. Follow‐up showed normal left ventricular function and no AS. Conclusion: This is the first reported case of ALVT and critical AS that underwent successful neonatal Ross procedure.

Surgical repair of aortico-left ventricular tunnel: report of two cases

Two girls aged 1 and 15 years with heart murmurs were diagnosed with aortico-left ventricular tunnel. In the 1-year-old, the tunnel had an intracardiac aneurysm within the right ventricular outflow tract; both openings were closed The 15-year-old had no aneurysmal dilatation, but she had mild aortic regurgitation; the aortic opening of the tunnel was closed with a patch. Both girls had uneventful postoperative courses with excellent early results.

Congenital aortico-left ventricular tunnel in fetuses and infants.

Congenital aortico-left ventricular tunnel (ALVT) is a rare congenital heart disease. A 27-year-old woman was referred to us at 37weeks gestation with fetal cardiac enlargement. The left ventricle (LV) of the fetus was enlarged. Fetal aortic valve (AoV) ring diameter spread was observed. Back flow from the AoV margins to the LV was observed. The prenatal diagnosis of the fetus was aortic regurgitation (AR). A male neonate was delivered by cesarean section at 40weeks gestation. We made the diagnosis of ALVT because the aorta and the LV of the neonate showed a tunnel with blood flow on echocardiography. We took another look at the fetal echocardiography. The neonate underwent surgery for exacerbation of heart failure on the 7th day after birth. Trivial flow from the tunnel and mild AR were observed after surgery.

Percutaneous device closure of aortico-left ventricular tunnel using Amplatzer vascular plug III

Aortico-left ventricular tunnel is a rare congenital heart defect. Reports on successful device closure of these defects are scarce. We are reporting the first case of device closure of aortico-left ventricular tunnel using an Amplatzer vascular plug III.

Aortico-Left Ventricular Tunnel: The Elusive Diagnosis

We present a case of an infant prenatally diagnosed with bilateral outflow-tract obstruction and severe aortic regurgitation who underwent cardiac transplantation at 45 days of life. Aortico-left ventricular tunnel was subsequently diagnosed on pathologic examination of the explant heart. Aortico-left ventricular tunnel is a rare congenital cardiac malformation and can remain undiagnosed if the clinician has a low level of suspicion. Aortico-left ventricular tunnel should be considered in any fetus or newborn with aortic regurgitation.

Value of echocardiography in the diagnosis of aortico-left ventricular tunnel

Objective To evaluate the clinical value of echocardiography in the diagnosis of aorticoleft ventricular tunnel.Methods The echocardiographic and clinical characteristics were retrospectively analyzed in 6 patients with aortico-left ventricular tunnel we reported and 147 cases that documents reported.Results Six patients were confirmed by operation.The main echocardiographic characteristics of aortico-left ventricular tunnel were as follows:An abnormal communication began in the ascending aorta above the level of the coronary arteries,bypassed the aortic valve,and terminated in the left ventricle.The color Doppler flow imaging demonstrated to-and-fro flow,with or without aortic valve involvement.According Hovaguimian and his colleagues,2 cases were type Ⅰ,2 cases were type Ⅲ,1 case was type Ⅳ,1 case was type Ⅱ (showed as recanalization).Base on all of the 153 patients that we and documents reported,the accuracy rate of ultrasound diagnosis was 79.6％,the misdiagnosis rate was 17.1％,and missed diagnosis rate was 3.3 ％.Conclusions Echocardiography is the non-invasive and sensitive tool in the diagnosis of the type of aortico-left ventricular tunnel and structure of cardiac involvement,and is the preferred method for preoperative. Key words: Echocardiography; Heart defects,congenital; Aortico-left ventricular tunnel

The Value of Live Three‐Dimensional Echocardiography in an Adult Patient with Aortico‐Left Ventricular Tunnel

Aortico-left ventricular tunnel (ALVT) is a rare cardiac abnormality. This article presents an adult case of ALVT with aortic ostium lying above the left-noncommissure which was diagnosed with live three-dimensional echocardiography (3DE). Live 3DE has shown its value in providing more detailed information.

Case Series of Antenatally Diagnosed Aortico-Left Ventricular Tunnel

Aortico-left ventricular tunnel (ALVT), a rare congenital anomaly was first reported in 1963 by Levy et al. [3]. It is an extracardiac channel that connects the ascending aorta above the sinutubular junction and the left ventricular cavity. There might be associated cardiac anomalies like valvular defects and abnormal coronary arteries. In the past, this anomaly was diagnosed in the postnatal period. With greater advances in fetal medicine, it is now possible to diagnose this condition antenatally.