"The first case, an aorto-left ventricular tract, was reported in 1957 by Jesse E Edwards (1912-2008), American cardiac pathologist 5, and Howard B Burchell (1908-2009), American cardiologist 4."
"Parasternal long and short axis views (at the base/aortic valve level) may demonstrate a dilated left ventricle, increased wall thickness, with a normal or decreased ejection fraction/global systolic function. Modification of the scanning plane may be necessary to fully visualise the aortic root which is often dilated; the origin of the tunnel is most commonly cephalad to the right sinus of valsalva. The tunnel will most commonly travel anteriorly, just deep to the RVOT and the pulmonary arteries before diving into the outlet portion (i.e. supra-cristal) of the interventricular septum becoming contiguous with the left ventricular outflow tract just below the annulus of the aortic valve. The tunnel (less commonly) may also drain into the right ventricle (particularly the outflow tract) 9."
"Parasternal long and short axis views (at the base/aortic valve level) may demonstrate a dilated left ventricle, increased wall thickness, with a normal or decreased ejection fraction/global systolic function. Modification of the scanning plane may be necessary to fully visualise the aortic root which is often dilated; the origin of the tunnel is most commonly cephalad to the right sinus of valsalva. The tunnel will most commonly travel anteriorly, just deep to the RVOT and the pulmonary arteries before diving into the outlet portion (i.e. supra-cristal) of the interventricular septum becoming contiguous with the left ventricular outflow tract just below the annulus of the aortic valve. The tunnel (less commonly) may also drain into the right ventricle (particularly the outflow tract) 9."
"MR angiography"
"Differential Diagnosis"
Expected headings
"Echocardiography"
"MR angiography"
"Cardiac catheterisation angiography"
"Differential Diagnosis"
"Approximately 130 cases have been described in the literature, with an estimated prevalence ranging from ~0.001% to ~0.1% of all cases of congenital heart disease 1,4. There is a clear male predilection of 2:1, male: female cases. Very few cases have been seen in those with African or Asian ethnicity 4. In ~90% of cases, the connection is between the aorta and the left ventricle; a right ventricle connection only occurs in ~10%."
"Approximately 130 cases have been described in the literature, with an estimated prevalence ranging from ~0.001% to ~0.1% of all cases of congenital heart disease 1,4. There is a clear male predilection of 2:1, male: female cases. Very few cases have been seen in those with African or Asian ethnicity 4. In ~90% of cases, the connection is between the aorta and the left ventricle; a right ventricle connection only occurs in ~10%."
"Parasternal long and short axis views (at the base/aortic valve level) may demonstrate a dilated left ventricle, increased wall thickness, with a normal or decreased ejection fraction/global systolic function. Modification of the scanning plane may be necessary to fully visualise the aortic root which is often dilated; the origin of the tunnel is most commonly cephalad to the right sinus of valsalva. The tunnel will most commonly travel anteriorly, just deep to the RVOT and the pulmonary arteries before diving into the outlet portion (i.e. supra-cristal) of the interventricular septum becoming contiguous with the left ventricular outflow tract just below the annulus of the aortic valve. The tunnel (less commonly) may also drain into the right ventricle (particularly the outflow tract) 9."
"Associated anomalies of the aortic valve, coronary origins, and ventricular septal defects should also be noted; the membranous ventricular septum may be posteriorly deviated forming a malalignment VSD with right ventricular outflow tract obstruction 7."
"Parasternal long and short axis views (at the base/aortic valve level) may demonstrate a dilated left ventricle, increased wall thickness, with a normal or decreased ejection fraction/global systolic function. Modification of the scanning plane may be necessary to fully visualise the aortic root which is often dilated; the origin of the tunnel is most commonly cephalad to the right sinus of valsalva. The tunnel will most commonly travel anteriorly, just deep to the RVOT and the pulmonary arteries before diving into the outlet portion (i.e. supra-cristal) of the interventricular septum becoming contiguous with the left ventricular outflow tract just below the annulus of the aortic valve. The tunnel (less commonly) may also drain into the right ventricle (particularly the outflow tract) 9."
"Colour flow and spectral Doppler are essential to define the direction, velocity and magnitude of blood flow, especially the diastolic regurgitation jets flowing from the tunnel into the LVOT with or without aortic valvular regurgitation. Quantification of severity (e.g. by pressure half time) should be noted. Apical 5 chamber and long axis views are complimentary, and may provide more optimal Doppler alignment with regurgitation jets to enhance detection and quantification 8."