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Aorto-left ventricular tunnel: case series of a rare disease

Obayda M Diraneyya1,2, Fahad Alhabshan1,2,3, Abdullah Alghamdi1,2,3

  • 1Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

Cardiology in the Young
|October 19, 2020
PubMed

Insights

Aorto-left ventricular tunnel (ALVT) is a rare congenital heart defect. Early surgical repair of ALVT is recommended for a good outcome, though long-term monitoring of aortic valve function is crucial.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Aorto-left ventricular tunnel (ALVT) is a rare congenital heart defect associated with significant early-life morbidity.
  • Volume overload and left ventricular failure are common complications of ALVT.
  • While surgical intervention is often curative, long-term outcomes require further investigation.

Purpose of the Study:

  • To report a case series of aorto-left ventricular tunnel (ALVT).
  • To evaluate the long-term outcomes of surgically repaired ALVT in pediatric patients.

Main Methods:

  • Retrospective analysis of pediatric patients (birth to 14 years) diagnosed with ALVT between 2001 and 2020.
  • Collection and review of demographic, echocardiographic, and perioperative data.
  • Comparison of pre-operative data with last outpatient follow-up data.

Main Results:

  • Five patients with ALVT were included; presentations varied from incidental murmurs to congestive heart failure.
  • Two patients had aortic valve stenosis/regurgitation with depressed LV function; three had normal aortic valves and ventricular function.
  • All patients underwent surgical repair with no residual ALVT; however, two developed moderate aortic regurgitation and one had moderate aortic stenosis during follow-up.

Conclusions:

  • Aorto-left ventricular tunnel (ALVT) presents with a spectrum of clinical manifestations.
  • Early surgical repair of ALVT is recommended for complete resolution.
  • Long-term follow-up is essential to monitor for aortic root dilatation and ensure timely management of aortic valve competency.
Abstract

Keywords:
CHDaorto-left ventricular tunnelcardiac surgerypaediatric cardiology

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