Diagnostic Features, Surgical Treatment, and Postoperative Follow-up of the Aortic-Left Ventricular Tunnel

This report of 3 cases of aortic-left ventricular tunnel describes the clinical features, cross-sectional echocardiographic and angiocardiographic studies, surgical technique, and postoperative follow-up. Left ventricular hypertrophy was apparent in the electrocardiogram of each patient, and the chest x-rays showed marked cardiomegaly and dilatation of the ascending aorta. The echocardiographic parasternal long-axis view and the parasternal short- axis view allowed the correct diagnosis of the aortic-left ventricular tunnel, and the Doppler study showed aortic valve regurgitation in all patients. The left ventriculogram and aortogram in right anterior oblique view were very important for diagnosis and permitted visualization of the tunnel in all cases. The surgical technique consisted of the closure of the aortic and ventricular ends of the tunnel with a reinforced patch repair to reestablish the attachment between the unsupported aortic annulus and the ventricular septum. At the postoperative follow-up, the 3 patients have mild aortic valve regurgi tation that has not increased to the present.