[A case of aorta-to-left ventricle tunnel accompanied by electrocardiographic modifications]

A new case of aorta-to-left ventricule tunnel is described in a young man of 20. The clinical picture was that of a typical and severe aortic incompetence combined with intermittent left bundle-branch block. During operation a typical aorta-to-left ventricle tunnel was found located above the right aorta Valsava sinus. The aortic valve was normal. The tunnel was closed at both extremities and extracorporeal circulation, which resulted in abolition of the aortic incompetence and disappearance of the left bundlebranch block. The literature at out disposal indicates that till now, thirteen other cases were described, since Morris Levy described the first in 1963. The anomaly might be corrected. On the fourteen cases, nine were operated upon, six of which successfully. We feel that the left bundle-branch block was probably caused by the mechanical trauma to the conduction pathway caused by the regurgitation, in view of the proximity between the left bundle-branch and the tunnel. Obliteration of the tunnel resulted in abolition of the traumatic effect and consequently disappearance of the left bundle-branch block.