Imaging diagnosis and surgical treatment of four cases of congenital aortic-left ventricular tunnel

XIONG Qing-feng; MA Xiao-jing; CHEN Xin; YU Zheng-chun; LI Wei; XU Juan; CHEN Xian-feng; PENG Zhi-yuan

Journal of China Clinic Medical Imaging ›› 2015, Vol. 26 ›› Issue (4) : 251-254.

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Imaging diagnosis and surgical treatment of four cases of congenital aortic-left ventricular tunnel

XIONG Qing-feng, MA Xiao-jing, CHEN Xin, YU Zheng-chun, LI Wei, XU Juan, CHEN Xian-feng, PENG Zhi-yuan

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Abstract

Objective: To evaluate the imaging diagnosis and surgical treatment of aortic-left ventricular tunnel. Methods: Four cases(2 males and 2 females) of congenital aortic-left ventricular tunnel(ALVT) were analyzed retrospectively, age ranged from 2 to 5 years. All patients were diagnosed by multi-spiral CTA(MSCTA) and echocardiography. Results: MSCTA and echocardiography showed the tunnel that bypassed the aortic valve and terminated in the left ventricle chamber. There were 1 case of ALVT with type Ⅲ and 3 cases with type Ⅱ. Two cases had a tunnel of 5~6 mm to the outflow tract of left ventricle, moderate aortic regurgitation and mildly dilated ascending aorta, and located at the edge of the aortic root between the left and right sinus approximating to the aortic valve(type Ⅱ). One case had a tunnel of 5~6 mm to the chamber of left ventricle and aneurism-like enlargement of the Valsalva sinus between the left sinus and ante-latus wall of left ventricle(type Ⅱ). One case had a tunnel of 4~5 mm, associated with moderate to severe aortic regurgitation, located at the edge of the aortic root between the right and noncoronary sinus approximating to the aortic valve, with an aneurysm located at the perimembranous ventricular septum sticking out to the outflow tract of right ventricular(type Ⅲ). One case was discharged without surgery. Three cases were operated with better functional results. The operation showed an abnormal tunnel that bypassed the aortic valve and terminated in the left ventricle chamber and showed the dilated ascending aorta with an aneurism-like enlargement of the Valsalva sinus, and the aneurysm sticking out to the outflow of right ventricle could also be seen at the perimembranous ventricular septum. The aortic regurgitation was detected in 2 cases. The aortic-left ventricular tunnel repair and the aortic valvuloplasty were performed. Conclusion: Aortic-left ventricular tunnel is a rare congenital abnormal communication between the aorta and the left ventricle. Since they are often accompanied with moderate to severe aortic regurgitation resulting in myocardial remodeling and congestive heart failure, aortic-left ventricular tunnel should be diagnosed and treated early.

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Heart defects / congenital / Echocardiography / Tomography / spiral computed / Angiography

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XIONG Qing-feng;MA Xiao-jing;CHEN Xin;YU Zheng-chun;LI Wei;XU Juan;CHEN Xian-feng;PENG Zhi-yuan. Imaging diagnosis and surgical treatment of four cases of congenital aortic-left ventricular tunnel[J]. Journal of China Clinic Medical Imaging. 2015, 26(4): 251-254