[Surgical treatment of aortico-left ventricular tunnel]

Abstract

Objective: To review 9 aortico-left ventricular tunnel (ALVT) patients in our hospital, describe the clinical features, diagnosis, treatments and follow-up.

Methods: We identified 9 patients from July 2002 to August 2008. Clinical and surgical details were reviewed. 7 patients were in NYHA class I and 2 in class III, 8 of 9 patients were diagnosed by echocardiography before operation.

Results: All patients underwent surgery under standard cardiopulmonary bypass. 2 with direct suture, 5 by patch closure of the aortic end and 1 by patch closure of both aortic end and left ventricular end of the AVLT. 1 underwent aortic valve replacement after incision of the ALVT. One patient died 2 month after operation because of endocarditis and acute heart failure. At follow-up (3 month to 6 years), 3 patients were in NYHA class I, 3 in Class II, 1 in class III and missed 1. No aortic regurgitation or trace in 2, little in 1, little to moderate in 2. The aortic mechanical valve is normal in 1 and paravalvular leakage in 1 patient.

Conclusion: Aortico-left ventricular tunnel is a rare cardiac malformation with a good post-operative outcome. Surgery is an effective treatment. Long-term follow-up for post-operation is essential.