Wang Wei, Sun Hai-Ning, Yang Ke-Ming, Luo Xin-Jin, Hu Sheng-Shou
Department of Cardiac Surgery, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Sep;37(9):823-5.
To review 9 aortico-left ventricular tunnel (ALVT) patients in our hospital, describe the clinical features, diagnosis, treatments and follow-up.
We identified 9 patients from July 2002 to August 2008. Clinical and surgical details were reviewed. 7 patients were in NYHA class I and 2 in class III, 8 of 9 patients were diagnosed by echocardiography before operation.
All patients underwent surgery under standard cardiopulmonary bypass. 2 with direct suture, 5 by patch closure of the aortic end and 1 by patch closure of both aortic end and left ventricular end of the AVLT. 1 underwent aortic valve replacement after incision of the ALVT. One patient died 2 month after operation because of endocarditis and acute heart failure. At follow-up (3 month to 6 years), 3 patients were in NYHA class I, 3 in Class II, 1 in class III and missed 1. No aortic regurgitation or trace in 2, little in 1, little to moderate in 2. The aortic mechanical valve is normal in 1 and paravalvular leakage in 1 patient.
Aortico-left ventricular tunnel is a rare cardiac malformation with a good post-operative outcome. Surgery is an effective treatment. Long-term follow-up for post-operation is essential.
回顾我院9例主动脉-左心室隧道（ALVT）患者的临床资料，描述其临床特征、诊断、治疗及随访情况。
选取2002年7月至2008年8月间9例患者，回顾其临床及手术细节。7例患者心功能纽约心脏病协会（NYHA）分级为I级，2例为III级，9例患者中有8例术前经超声心动图确诊。
所有患者均在标准体外循环下行手术治疗。2例行直接缝合，5例行主动脉端补片修补，1例行主动脉端及左心室端补片修补。1例在切开ALVT后行主动脉瓣置换术。1例患者术后2个月因心内膜炎及急性心力衰竭死亡。随访（3个月至6年），3例患者NYHA分级为I级，3例为II级，1例为III级，1例失访。2例无主动脉反流或微量反流，1例少量反流，2例少量至中度反流。1例患者主动脉机械瓣正常，1例有瓣周漏。
主动脉-左心室隧道是一种罕见的心脏畸形，术后效果良好。手术是有效的治疗方法。术后长期随访至关重要。
