Imaging and surgical repair of a bifurcating aortico-left ventricle tunnel

Aortico-left ventricle tunnels are rare congenital anomalies with variable anatomy; however, by definition, they consist of an abnormal connection between the ascending aorta and the left ventricle. Diagnosis is usually by echocardiography, and treatment typically uses a two-patch surgical repair. Herein, we describe a case of an aortico-left ventricle tunnel, with the tunnel bifurcating before entering the left ventricle. Preoperative echocardiography and magnetic resonance imaging show the lesion in great detail. Two patches were required on the left-ventricular side of the tunnel for closure. A bifurcating aortico-left ventricle tunnel has not yet been described in the literature. The preoperative imaging and surgical management are discussed.