Surgical treatment of aortico-left ventricular tunnel

P. Horvath, S. Balaji, S. Škovránek, B. Hučin, M. R. De Leval, J. Stark

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37 Scopus citations

Abstract

Thirteen children (age range 6 h-11 years, median 4 months) operated upon for aortico-left ventricular tunnel since 1971 are reported. All patients had systolic and diastolic murmurs, 4 of 5 neonates were in severe congestive heart failure. Twelve children had left ventricular hypertrophy on ECG with an ischaemic pattern in the neonates. Chest X-ray revealed cardiomegaly with a broad upper mediastinal shadow from the enlarged aorta. Echocardiography (2DE) revealed a tubular communication between the aorta and the left ventricle bypassing the aortic valve and massive regurgitation through this tunnel demonstrated by Doppler sonography. In 8 patients, the diagnosis was confirmed by angiography. The tunnel arose from the right coronary sinus in 12 and from the left coronary sinus in 1 patient. The tunnel was closed at both ends in 8, at the aortic end only in 3 and at the ventricular end in the remaining 2 cases. One 6-day-old infant, operated upon in 1971 died postoperatively. There was 1 non-cardiac related late death due to a brain tumour. Echocardiographic analysis of left ventricular size and function was carried out in 9 children up to 39 months after surgery. Mild to moderate aortic incompetence was detected during the follow-up period in 2 of 12 patients. All surviving children are leading normal lives. [Eur J Cardio-thorac Surg (1991) 5:113-117]

Original languageEnglish (US)
Pages (from-to)113-117
Number of pages5
JournalEuropean Journal of Cardio-Thoracic Surgery
Volume5
Issue number3
DOIs
StatePublished - Mar 1991

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Keywords

  • Aortico-left ventricular tunnel
  • Cardiac surgery
  • Echocardiography
  • Follow-up
  • Paediatric

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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