[Aortic-left ventricular tunnel--description of two cases]

This is a very rare congenital anomaly, which clinically imitates aortic insufficiency and therefore should be kept in mind by the cardiologist. Only an early precise diagnosis and proper surgical treatment will result in a good long-term prognosis. We have diagnosed and treated two patients, four and five years old, referred to us with a diagnosis of aortic insufficiency. Our final assessment was based on an obligatory cine-angio study, since a certain percentage of patients with this anomaly have concomitant lesions in the cardio-vascular system, which should be precisely detected. A brief differential diagnosis and discussion concerning different surgical techniques are presented. In our two cases obliteration of the tunnel using a Dacron patch inserted vertically in the tunnel with closure of both ostia was performed. This technique seems to be superior compared to the previous one in terms of preventing the progressive destruction of the aortic valve. All the authors agree that early surgical treatment is indicated before the left ventricle becomes dilated and the aortic valve significantly damaged. Two years post surgery our patients are in very good condition with: no signs and heart failure, a gradual diminution of the left ventricular cavity and satisfactory function of the aortic valve.