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Aortico–left ventricular tunnel: 35-year experience

Jose D. Martins, MD^*, Megan C. Sherwood, MBBS, FRACP^*,*, John E. Mayer, Jr, MD and John F. Keane, MD^*

^* Department of Cardiology, Children's Hospital, Boston, Massachusetts, USA
Department of Cardiac Surgery, Children's Hospital, Boston, Massachusetts, USA
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA

View larger version (66K): [in a new window]   Figure 1 Short-axis view of aortic valve (AoV). (A) The aortic end of the tunnel is not significantly dilated. It resembles an additional aortic leaflet, appearing like a quadricuspid AoV. (B) The tunnel is aneurysmal and resembles a pouch anterior to the aorta.

View larger version (94K): [in a new window]   Figure 2 (A) Long-axis view of the tunnel. (B) Diastolic regurgitation via the tunnel. Ao = aorta; LV = left ventricle.

View larger version (95K): [in a new window]   Figure 3 Power-assisted injection with a Berman catheter in the aortic–left ventricular tunnel (ALVT), in two orthogonal planes, right anterior oblique with caudal (A) and left anterior oblique with cranial (B) angulation. Ao = aorta; LV = left ventricle; V = ventricle.