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Aorto-Left Ventricular Tunnel

Aorto-Ventricular Tunnel


Presentation

  • Marked cardiomegaly and dilatation were present along with diffuse myocardial infarction.[ncbi.nlm.nih.gov]
  • The child was presented with left ventricular dilatation with early and progressive signs of congestive heart failure.[paperity.org]
  • A 25-year-old male presented to us with multiple episodes of syncope during the past 6 months.[circ.ahajournals.org]
Pulmonary Valve Stenosis
  • Pediatr Cardiol 1989;10:99-103. 21 Martin Jimenez J, Gonzales Diegues CC, Quero Jimenez C, Rico Gomez F, Bermudez Canete R, Quero Jimenez M: Aortico-left ventricular tunnel associated with pulmonary valve stenosis.[gerboni.net]
  • Martin Jimenez J, Gonzales Diegues CC, Quero Jimenez C, Rico Gomez F, Bermudez Canete R, Quero Jimenez M: Aortico-left ventricular tunnel associated with pulmonary valve stenosis. Rev Esp Cardiol. 1996, 49: 921-4. PubMed 22.[springermedizin.de]
  • Aortico-left ventricular tunnel associated with pulmonary valve stenosis. Rev Esp Cardiol. 1996; 49 :921–4. [ PubMed ] [ Google Scholar ] 11. Knott-Craig CJ, van der Merwe PL, Kalis NN, Hunter J.[ncbi.nlm.nih.gov]
Fatigue
  • Signs and symptoms of severe defects in newborns include Rapid breathing Cyanosis - a bluish tint to the skin, lips, and fingernails Fatigue Poor blood circulation Many congenital heart defects cause few or no signs and symptoms.[icdlist.com]
  • CASE REPORT An eight-month-old boy arrived in our department presenting with dyspnea and fatigue after the slightest effort, symptoms that had started one month previously.[bjcvs.org]
Marfanoid Habitus
  • However, although the patient did have a marfanoid habitus with a reduced upper to lower segment ratio and a positive wrist and thumb sign ( Figure 6 ), he did not meet the revised Ghent criteria for Marfan syndrome.[circ.ahajournals.org]
Pathologist
  • History and etymology 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. sinus of Valsalva fistula a sequela[radiopaedia.org]
Regurgitation
  • Besides, ALVT with BAV might easily lead to an inaccurate diagnose as aortic regurgitation caused by BAV.[ncbi.nlm.nih.gov]
To-and-Fro Murmur
  • On physical examination, a "to-and-fro" murmur may be appreciated on precordial auscultation, along with an easily palpable pulse (due to rapid aortic runoff).[radiopaedia.org]
  • To and fro murmur was present in all patients. Cardiomegaly with cardiothoracic ratio of more than 0.7 was universal in the study group. ECG showed significant left ventricular forces. TTE confirmed the diagnosis in all cases.[ncbi.nlm.nih.gov]
Wide Pulse Pressure
  • There was wide pulse pressure and signs of aortic run off in all. To and fro murmur was present in all patients. Cardiomegaly with cardiothoracic ratio of more than 0.7 was universal in the study group.[ncbi.nlm.nih.gov]
Bounding Pulse
  • Clinical description A loud "to-and-fro" murmur, usually with systolic and diastolic thrills, invariably radiates over the entire precordium in aorto-ventricular tunnel, and bounding pulses indicate rapid aortic run-off.[ncbi.nlm.nih.gov]

Workup

  • Two-dimensional (2D) echocardiography with color Doppler imaging is the current modality of choice to establish the diagnosis of SAS (see Workup).[emedicine.medscape.com]

Treatment

  • Clinical implications of antenatal diagnosis on postnatal treatment and outcome are also discussed.[ncbi.nlm.nih.gov]
  • Emphasizes the treatment of corrected congenital heart disease for coverage of the clinical management of cardiac problems in the adolescent and young adult.[books.google.com]
  • The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]

Prognosis

  • Treatment and prognosis In the majority of cases, even when the patient is asymptomatic, early surgical intervention is required to prevent permanent left ventricular dysfunction.[radiopaedia.org]
  • Rarely, aortic dilatation is seen in early infancy, with very poor prognosis. 3 The prevalence of both aortic dilatation and mitral valve prolapse in pediatric cohorts is approximately 80%. 1 Aortic regurgitation develops as a complication of aortic dilatation[radiologykey.com]
  • Prognosis Although natural history studies have not delineated the annual mortality rate, 2-10% of sudden deaths are reported in untreated individuals with severe left ventricular outflow tract (LVOT) obstruction, including subvalvar aortic stenosis ([emedicine.medscape.com]
  • It is the form with favorable prognosis and better survival at 5 and 10 years. Our study tries to systematize the debut forms of early gastric cancer and their association with the lesions with malignisation risk.[rjme.ro]

Etiology

  • Etiology The etiology of aorto-ventricular tunnel is uncertain. It appears to result from a combination of maldevelopment of the cushions which give rise to the pulmonary and aortic roots, and abnormal separation of these structures.[orpha.net]
  • There were many speculations about etiology of the tunnel, ranging from congenital to acquired nature of the defect.[ncbi.nlm.nih.gov]

Epidemiology

  • Summary Epidemiology The exact incidence is unknown, estimates ranging from 0.5% of fetal cardiac malformations to less than 0.1% of congenitally malformed hearts in clinico-pathological series.[orpha.net]
  • Epidemiology The incidence of aorto-left ventricular tunnel has been variably estimated to be around 0.1% of congenitally malformed hearts from review of clinical and pathological material [ 25 ], 0.05% among patients undergoing cardiac catheterization[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • (See Pathophysiology and Treatment and Management.) Go to Aortic Stenosis for more complete information on this topic.[emedicine.medscape.com]

Prevention

  • Treatment and prognosis In the majority of cases, even when the patient is asymptomatic, early surgical intervention is required to prevent permanent left ventricular dysfunction.[radiopaedia.org]
  • Progressive aneurysmal dilatation of the aortic root in patients repaired at an older age is important and avoidable because of aortic regurgitation.[ 24 ] Hence, early correction is indicated not only to prevent heart failure but also to prevent progression[ncbi.nlm.nih.gov]

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