Girisch M, Kaulitz R, Rauch R, Ziemer G, Salehi-Gilani S, Hofbeck M
Abteilung für Kinderkardiologie der Klinik für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Tübingen.
Ultraschall Med. 2003 Aug;24(4):264-9. doi: 10.1055/s-2003-41710.
AIM/METHOD: The aorto-left ventricular tunnel (ALVT) is a rare congenital cardiac malformation with clinical findings of severe aortic insufficiency. We report the echocardiographic differentiation of different anatomical variants of ALVT in two infants.
Echocardiography in both patients demonstrated severe enlargement of the ascending aorta and the left ventricle. In the first patient the ALVT originated from the ascending aorta above the right coronary sinus and entered the left ventricle just below the aortic valve. In the second patient the ALVT originated above the left coronary sinus and took a lateral course to the left ventricle. Colour-Doppler-sonography in both patients confirmed a systolic-diastolic flow across the tunnel. Many patients have associated cardiac defects. Exact determination of the morphology of the aortic valve and coronary arteries is mandatory for surgical repair. Postoperative follow-up studies focus on the function of the aortic valve and the left ventricle.
Differentiation of different anatomical variants of ALVT is possible trough echocardiography. Cardiac catheterization is required only in cases with inadequate information about coronary artery anatomy.
目的/方法：主动脉-左心室隧道（ALVT）是一种罕见的先天性心脏畸形，临床表现为严重的主动脉瓣关闭不全。我们报告了两例婴儿中不同解剖变异型ALVT的超声心动图鉴别诊断。
两名患者的超声心动图均显示升主动脉和左心室严重扩大。第一例患者的ALVT起源于右冠状动脉窦上方的升主动脉，并在主动脉瓣下方进入左心室。第二例患者的ALVT起源于左冠状动脉窦上方，并向左心室走行于外侧。两名患者的彩色多普勒超声均证实了隧道内的收缩期-舒张期血流。许多患者伴有心脏缺陷。精确确定主动脉瓣和冠状动脉的形态对于手术修复至关重要。术后随访研究重点关注主动脉瓣和左心室的功能。
通过超声心动图可以鉴别ALVT的不同解剖变异型。仅在冠状动脉解剖信息不足的情况下才需要进行心导管检查。
