Jian Linhao, Zhang Zhixiang, Chen Dexiang, Ge Liangqing
Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University, 818 Renmin Avenue, Changde City, 415003, China.
Department of Cardiac Surgery, Changde Hospital, Xiangya School of Medicine, Central South University, 818 Renmin Avenue, Changde City, 415003, China.
Heliyon. 2024 Sep 27;10(19):e38644. doi: 10.1016/j.heliyon.2024.e38644. eCollection 2024 Oct 15.
Aortico-left ventricular tunnel (ALVT) is a rare congenital disease characterised by extracardiac channel communication between the ascending aorta and the ventricle. However, there have been no reports of ALVT compressing the coronary arteries. Here, we report the case of a 57-year-old woman who presented with unstable angina due to right coronary artery compression caused by a giant aneurysmal ALVT. Preoperative imaging failed to accurately diagnose this rare anomaly. Finally, we combined surgical exploration and a three-dimensional reconstruction technique to diagnose ALVT. After surgical resection of the aneurysm and repair of the tunnel, the patient's angina resolved. This case illustrates the importance of recognising extrinsic compression of the coronary artery as a potential cause of angina pectoris. It also highlights that ALVT with atypical anatomical features may require multiple imaging techniques and even surgical exploration to confirm the diagnosis.
主动脉-左心室通道（ALVT）是一种罕见的先天性疾病，其特征是升主动脉与心室之间存在心外通道连通。然而，此前尚无ALVT压迫冠状动脉的报道。在此，我们报告一例57岁女性患者，因巨大动脉瘤样ALVT压迫右冠状动脉而出现不稳定型心绞痛。术前影像学检查未能准确诊断这一罕见异常。最终，我们结合手术探查和三维重建技术诊断出ALVT。在手术切除动脉瘤并修复通道后，患者的心绞痛症状得到缓解。该病例说明了认识到冠状动脉外部压迫作为心绞痛潜在病因的重要性。它还强调了具有非典型解剖特征的ALVT可能需要多种成像技术甚至手术探查来确诊。
