Ruschewski W, de Vivie E R, Kirchhoff P G
Thorac Cardiovasc Surg. 1981 Oct;29(5):282-6. doi: 10.1055/s-2007-1023496.
Aortico-left ventricular tunnel (ALVT) is a very rare cardiac malformation with only 25 cases having been reported in the literature. This paper describes another 5 cases with surgical repair at the ages of 4, 5, 6, and 14 years, respectively. (A fifth case in an 11-year-old boy was operated upon just recently and is described separately in the addendum). The anatomical and clinical findings and diagnostic procedures including angiocardiography are reviewed. The surgical management is discussed, and the late results after follow-up periods of 5, 11, 13, and 16 years are presented. Three patients are doing well although showing clinical signs of mild aortic valve insufficiency, and one patient required aortic valve replacement 13 years after operation because of massive aortic regurgitation. Early surgical repair is recommended as soon as the diagnosis is established by angiocardiography in order to prevent secondary aortic valve lesion by dilatation of the aortic ring and aneurysmatic dilatation of the ventricular septum.
主动脉-左心室通道(ALVT)是一种非常罕见的心脏畸形,文献中仅报道过25例。本文描述了另外5例分别在4岁、5岁、6岁和14岁接受手术修复的病例。(一名11岁男孩的第五例病例最近刚接受手术,在附录中单独描述)。回顾了解剖和临床发现以及包括心血管造影在内的诊断程序。讨论了手术治疗方法,并给出了5年、11年、13年和16年随访期后的远期结果。3例患者情况良好,尽管有轻度主动脉瓣关闭不全的临床体征,1例患者在术后13年因大量主动脉反流需要进行主动脉瓣置换。一旦通过心血管造影确诊,建议尽早进行手术修复,以防止因主动脉环扩张和室间隔瘤样扩张导致继发性主动脉瓣病变。