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. 2012 Dec;20(12):509-12.
doi: 10.1007/s12471-012-0330-6.

Two cases of aorto-right atrial tunnel: clinical presentation, imaging and percutaneous closure

R J de Winter  1 , N A Blom, B Straver, B J Bouma, A P C M Backx, S A Clur, I M Kuipers, F Hoekstra, S M Boekholdt, M Groenink, D R Koolbergen, M G Hazekamp, B J M Mulder
Affiliations

Two cases of aorto-right atrial tunnel: clinical presentation, imaging and percutaneous closure

R J de Winter et al. Neth Heart J. 2012 Dec.

Abstract

Communication between the aortic sinus and a cardiac chamber is a rare anomaly that can be diagnosed in children and young adults. We describe two cases with a tunnel between the aortic sinus and right atrium, discuss diagnostic modalities, and review the literature on this anomaly.

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Figures

Fig. 1
Fig. 1
Echocardiographic transthoracic 4-chamber view with colour Doppler, showing continuous flow inside the tunnel with turbulent flow at the connection with the right atrium
Fig. 2
Fig. 2
Angiographic still frames, showing the relation of the entrance of the aorto-right-atrium-tunnel (ARAT) with the left coronary sinus, the left coronary artery and the continuation of the tunnel towards the right atrium. a frontal view. b lateral view
Fig. 3
Fig. 3
A guiding catheter was advanced via the aorto to the entrance of the tunnel, a wire was passed through the tunnel and snared in the right atrium. Subsequently, a large guiding catheter was passed from the right atrium into the tunnel and the device was positioned
Fig. 4
Fig. 4
a. Shortly after the first device placement, the flow through the tunnel was absent. b. After placement of the second device, the next day, again the tunnel was closed
Fig. 5
Fig. 5
Angiographic image of case 2, demonstrating a similar aorto-right-atrial tunnel connecting the left coronary sinus to the right atrium with a posterior tunnel
See this image and copyright information in PMC

References

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