Evolution in the management of aorta to left ventricular tunnel in a national congenital cardiology centre

Abstract

An aorto-ventricular tunnel is a rare congenital cardiac defect, where a channel connects the lumen of the ascending aorta to the left or right ventricle. Four patients presented with an aorto-left ventricular tunnel over two decades at a median age of 8 months (range 0.1–10 months). Two patients (50%) had associated cardiac anomalies including hypoplastic left heart syndrome and left ventricular noncompaction/hypertrophic cardiomyopathy with aortic/pulmonary valve dysplasia in one patient each. Although traditionally surgical treatment has addressed this problem, management has evolved to transcatheter closure with excellent outcomes in appropriately selected patients at our national centre.

Multimodality imaging for comprehensive non‐invasive diagnosis of aorto‐left ventricular tunnel in infancy

“…Few other cases were reported in pediatric patients using variable devices such as vascular plugs, ductal and muscular occluders. 4,[19][20][21] In our patient, we opted for the surgical approach owing to the young age of the patient with a large tunnel, the proximity of the tunnel to the right coronary artery, and the possible risk of aortic valve damage or distortion by the used device with potential consequent aortic regurgitation.…”