Clinical value of diagnosing aortico-left ventricular tunnel by echocardiography

Xie,Manying; Yin,Jiabao; Lv,Qing; Wang,Jing

doi:10.3892/etm.2016.3747

Clinical value of diagnosing aortico-left ventricular tunnel by echocardiography

Authors:
- Manying Xie
- Jiabao Yin
- Qing Lv
- Jing Wang
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Affiliations: Department of Ultrasound Imaging, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China, Department of Ultrasound Imaging, Xiehe Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
Published online on: September 23, 2016 https://doi.org/10.3892/etm.2016.3747
Pages: 3315-3319
Copyright: © Xie et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

In order to assess the clinical value of echocardiography in the diagnosis of aortico-left ventricular tunnel (ALVT) the echocardiographic data and clinical manifestations of six patients with ALVT were analyzed in the present study. Based on the results, a comprehensive study was conducted regarding 147 cases from related documents. Six patients were confirmed with ALVT by surgery. The echocardiographic images of the patients revealed an abnormal communication beginning in the ascending aorta above the coronary arteries, bypassing the aortic valve, and ending in the left ventricle. The color Doppler flow imaging showed a high-speed to- and -fro flow with or without the involvement of the aortic valve. According to Hovaguimian type casting, there were two cases of type Ⅰ, two cases of type Ⅲ, one case of type Ⅳ, and one case of type Ⅱ (postoperative recanalization). Of the 153 cases reported, the accuracy rate of the ultrasound diagnosis was 79.6%, the misdiagnosis rate was 17.1%, and the missed diagnostic rate was 3.3%. In conclusion, echocardiography is the preferred method for non‑invasive preoperative diagnosis of the ALVT and can accurately describe the type and involvement of the cardiac structure.

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1	Edwards JE: An atlas of acquired disease of the heart and great vessels. 2. 2nd. WB Saunders; Philadelphia: pp. 11421961
2	Levy MJ, Lillehei CW, Anderson RC, Amplatz K and Edwards JE: Aortico-left ventricular tunnel. Circulation. 27:841–853. 1963. View Article : Google Scholar
3	Hovaguimian H, Cobanoglu A and Starr A: Aortico-left ventricular tunnel: a clinical review and new surgical classification. Ann Thorac Surg. 45:106–112. 1988. View Article : Google Scholar : PubMed/NCBI
4	Cooley RN, Harris LC and Rodin AE: Abnormal communication between the aorta and left ventricle; aortico-left ventricular tunnel. Circulation. 31:564–571. 1965. View Article : Google Scholar : PubMed/NCBI
5	Terada T, Sakurai H, Nonaka T, Sakurai T, Sugiura J and Otsuka R: Surgical repair of aortic regurgitation with left ventricular aneurysm diagnosed preoperatively as aortico-left ventricular tunnel. World J Pediatr Congenit Heart Surg. 5:583–585. 2014. View Article : Google Scholar : PubMed/NCBI
6	Martins JD, Sherwood MC, Mayer JE Jr and Keane JF: Aortico-left ventricular tunnel: 35-year experience. J Am Coll Cardiol. 44:446–450. 2004. View Article : Google Scholar : PubMed/NCBI
7	Cook AC, Fagg NL, Ho SY, Groves AM, Sharland GK, Anderson RH and Allan LD: Echocardiographic-anatomical correlations in aorto-left ventricular tunnel. Br Heart J. 74:443–448. 1995. View Article : Google Scholar : PubMed/NCBI
8	Hucin B, Horvath P, Skovránek J, Reich O and Samánek M: Correction of aortico-left ventricular tunnel during the first day of life. Ann Thorac Surg. 47:254–256. 1989. View Article : Google Scholar : PubMed/NCBI
9	Huang XS, Hou YS, Feng B, He Y, Xu Y and Huang ZG: Transthoracic and transesophageal echocardiography in the diagnosis of aortico-left ventricular tunnel. Chinese J Ultrasound Med. 20:304–307. 2004.(In Chinese).
10	Zhang HB, Xu ZW, Su ZZ and Ding WX: Diagnosis and surgical treatment of aortico-left ventricular tunnel. Chinese J Thoracic Cardiovas Surg. 20:268–270. 2004.(In Chinese).
11	Hou CJ, Deng DA, Zhu XY, Han XM, Wang QG, Sheng XT, Jin Y, Cui CS and Zhang P: A study on imaging characteristics of color Doppler echocardiography of aortic left ventricular tunnel. J China Clin Med Imaging. 17:34–36. 2006.(In Chinese).
12	Horváth P, Balaji S, Skovránek S, Hucin B, de Leval MR and Stark J: Surgical treatment of aortico-left ventricular tunnel. Eur J Cardiothorac Surg. 5:113–116; discussion 117. 1991. View Article : Google Scholar : PubMed/NCBI
13	Wang Q, Qiu LC, Shi HY and Wang LX: One case of advanced aortico-left ventricular tunnel. Chinese J Thoracic Cardiovas Surg. 22:3072006.(In Chinese).
14	Grünenfelder J, Zünd G, Prêtre R, Schmidli J, Vogt PR and Turina MI: Right coronary artery from aorto-left ventricular tunnel: case report of a new surgical approach. J Thorac Cardiovasc Surg. 116:363–365. 1998. View Article : Google Scholar : PubMed/NCBI
15	Zhu J, Jiang Z, Huang J, Wu S and Mei J: Aortico-left ventricular tunnel arising from the noncoronary sinus associated with a ventricular septal defect. Ann Thorac Surg. 98:e135–e137. 2014. View Article : Google Scholar : PubMed/NCBI
16	Pockett CR, Chan S and Smallhorn J: Aortico-left ventricular tunnel: the elusive diagnosis. Pediatr Cardiol. 34:1743–1745. 2013. View Article : Google Scholar : PubMed/NCBI
17	Smith BM, Cochran CD and Owens ST: Aortico-left ventricular tunnel and left ventricular non-compaction: a case series. Cardiol Young. 26:1–4. 2015.PubMed/NCBI
18	Thomas E, Maskari S and Farqani A: Percutaneous device closure of aortico-left ventricular tunnel using Amplatzer vascular plug III. Cardiol Young. 23:755–758. 2013. View Article : Google Scholar : PubMed/NCBI
19	Paech C, Pfeil N, Wagner R, Kostelka M and Weidenbach M: Smart nature. Aortico-left ventricular tunnel bypassing congenital critical aortic stenosis. Echocardiography. 30:E344–E345. 2013. View Article : Google Scholar : PubMed/NCBI
20	Shiraishi S, Takahashi M, Watanabe M and Tsuchida M: Surgical repair of aortico-left ventricular tunnel: report of two cases. Asian Cardiovasc Thorac Ann. 21:67–70. 2013. View Article : Google Scholar : PubMed/NCBI
21	Cebeci M, Kalayci S, Demirkan BM, Guray YA and Tufekcioglu O: Aortico-left ventricular tunnel with uncommon origin. Eur Heart J Cardiovasc Imaging. 15:9432014. View Article : Google Scholar : PubMed/NCBI
22	Li X, Zhao R, Liu B, Wang W, Yu Y, Shi X and Xu Y: Noninvasive imaging evaluation of aortico-left ventricular tunnel: a case report. Zhonghua Xin Xue Guan Bing Za Zhi. 42:345–346. 2014.(In Chinese). PubMed/NCBI
23	Song L, Jin J and Tao L: Surgical correction of an aortico-left ventricular tunnel originating from the left aortic sinus with a left coronary artery anomaly. J Card Surg. 30:108–110. 2015. View Article : Google Scholar : PubMed/NCBI
24	Bash SE, Huhta JC, Nihill MR, Vargo TA and Hallman GL: Aortico-left ventricular tunnel with ventricular septal defect: two-dimensional/Doppler echocardiographic diagnosis. J Am Coll Cardiol. 5:757–760. 1985. View Article : Google Scholar : PubMed/NCBI
25	Nezafati MH, Maleki MH, Javan H and Zirak N: Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva. J Card Surg. 25:345–346. 2010. View Article : Google Scholar : PubMed/NCBI
26	Myers JL and Mehta SM: Congenital Heart Surgery Nomenclature and Database Project: Aortico-left ventricular tunnel. Ann Thorac Surg. 69(Suppl 4): S164–S169. 2000. View Article : Google Scholar : PubMed/NCBI