Valvar aortico-ventricular tunnel: an insight into the development of the great arteries

Maghrabi, Khadijah; Gandhi, Sanjiv K.; Harris, Kevin C.

doi:10.1017/s1047951116001888

Cited by 2 publications

(5 citation statements)

References 10 publications

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Section: Resultsmentioning

confidence: 99%

“…The overall reported mortality for patients undergoing repair of isolated aorta-left ventricular tunnel prior to 1983 was around 20%. 1 …”

Section: Resultsmentioning

confidence: 99%

“…15 From the case reports and small case series, we were able to grade 106 descriptions on this basis, with 37 having slit-like orifices, 46 with extracardiac aneurysms, 15 with intracardiac aneurysms, and 8 with joint aneurysmal formation. [1][2][3][4][5][6][8][9][10][11][12][13][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][37][38][39] In the individuals reported from the joint multicenter registry, the aortic opening in 90% of both aortaleft ventricular and aorta-right ventricular tunnels was described as oval. 95 Several authors have noted that the segment of the sinutubular ridge closest to the orifice may be distorted or displaced, but continues to mark the distal limit of the sinus.…”

Section: Surgical Anatomymentioning

confidence: 99%

“…26,66,68,70 We now know that patients diagnosed during fetal life are likely to have severe ventricular dysfunction, associated lesions of the aortic valve, often with excessive left ventricular trabeculation, and have a poor outcome. 8,11,18,20,23,24,26,47,52,68,70,72,73,83,88 Those patients diagnosed after birth represent the more favorable end of the spectrum. Their natural course depends on the severity of coronary arterial anomalies, the degree of aortic regurgitation, and the presence of other associated lesions.…”

Section: Commentmentioning

confidence: 99%

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A Review of the Surgical Management of Aorto-ventricular Tunnels

Chowdhury

Anderson

George

et al. 2021

World J Pediatr Congenit Heart Surg

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We present a synthesis of 95 published investigations of the exceedingly rare tunnels that can exist between the aortic root and the left or right ventricles. From the 220 suitable cases included in these investigations, we reviewed the clinical presentations, modalities used for diagnosis, surgical approaches, and outcomes. Diagnostic information was provided by clinical presentation, radiographic findings, saline contrast echocardiography, computed tomographic angiocardiography, magnetic resonance imaging, cardiac catheterization, and angiocardiography. These techniques elucidated the coronary arterial origins and associated defects and defined the disease before surgery. Patients occasionally present with an asymptomatic cardiac murmur and cardiomegaly, but most suffer cardiac failure in the first year of life when the tunnel enters the left ventricle. Antenatal diagnosis by fetal echocardiography is reliable after 18 weeks of gestation. Associated defects, involving the proximal coronary arteries or the aortic or pulmonary valves, are present in nearly half the cases. Prompt diagnosis and surgical repair are important for a favorable outcome. Overall, operative mortality has been cited to be between 3% and 8.3%. Associated congenital coronary arterial anomalies, residual severe aortic stenosis, poor left ventricular function, and rupture of an infected suture line have been the reported causes of death. Despite early surgical intervention, an incidence of 16% to 60% postoperative residual aortic regurgitation of varying severity has been reported. The requirement of further repair or replacement of the aortic valve ranges from 0% to 50%. We submit that an increased appreciation of these details relative to the tunnels will contribute to improved surgical management.

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Section: Resultsmentioning

confidence: 99%

“…The overall reported mortality for patients undergoing repair of isolated aorta-left ventricular tunnel prior to 1983 was around 20%. 1 …”

Section: Resultsmentioning

confidence: 99%

Section: Surgical Anatomymentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

A Review of the Surgical Management of Aorto-ventricular Tunnels

Chowdhury

Anderson

George

et al. 2021

World J Pediatr Congenit Heart Surg

View full text Add to dashboard Cite

show abstract

“…The variabilities of clinical presentation result from hemodynamic changes depending on the size of tunnel diameter, the severity of compression of coronary arteries or narrowing of ventricular outflow tract [8]. Retrograde diastolic blood turbulence passing through the tunnel contribute to congestive heart failure eventually [9].…”

mentioning

confidence: 99%