Clinical value of diagnosing aortico-left ventricular tunnel by echocardiography

Abstract

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.

Keywords: aortico-left ventricular tunnel; congenital; echocariography; heart defects.

Figure 1.

Hovaguimian type III ultrasonogram. (A) Ventricular septal expansion of ALVT; (B) regurgitation signals seen in the tunnel during the period of diastole. ALVT, aortico-left ventricular tunnel.

Figure 2.

Hovaguimian IV sonogram, the mixed type of II and III. (A) The transesophageal echocardiography shows the aortic sinus wall and ventricular septal aneurysm expansion inside the tunnel; (B) the tunnel Shu. (B) A lot of regurgitation signals flow via the tunnel into the left ventricle.