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Surgical Management of Aorto-Ventricular Tunnel. A Multicenter Study
Eleftherios M Protopapas1, Robert H Anderson2, Carl L Backer3
1Department of Pediatric and Congenital Cardiac Surgery, Athens Heart Surgery Institute, Iaso Children's Hospital, Athens, Greece.
Seminars in Thoracic and Cardiovascular Surgery
|February 15, 2020
Summary
Aorto-ventricular tunnel (AoVT) is a rare congenital heart defect. Surgical repair, often involving patch closure and aortic valve repair, shows good outcomes for both left (AoLVT) and right (AoRVT) variants.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Pediatric Cardiac Surgery
Background:
- Aorto-ventricular tunnel (AoVT) is a rare congenital anomaly connecting the aorta to a ventricle.
- This condition requires surgical intervention, with variations in presentation and management.
Purpose of the Study:
- To review a 30-year surgical experience with aorto-ventricular tunnels (AoVT).
- To analyze surgical outcomes for left (AoLVT) and right (AoRVT) variants of AoVT.
Main Methods:
- Retrospective analysis of data from 15 centers on 42 patients undergoing AoVT correction (1987-2018).
- Review of surgical techniques, patient demographics, and clinical outcomes.
Main Results:
- AoLVT (36 patients) typically required early surgery (median 25 days), while AoRVT (6 patients) was repaired later (median 6 years).
- Patch closure of the aortic orifice was common for AoLVT. Aortic valve insufficiency was present in 30.5% of AoLVT patients.
- Early mortality was 7.14%, with good results reported for surgical repair.
Conclusions:
- AoVT is a rare malformation with distinct management pathways for AoLVT and AoRVT.
- Surgical repair, including patch closure and aortic valve management, yields favorable outcomes.
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