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A Rare Case of aortico-Right Ventricular Tunnel Along with Ventricular Septal Defect Presented as Ruptured Sinus of Valsalva in an Adult Female

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World Journal of Cardiovascular Surgery 2013年第3期3卷 119-121页

作者： Binay Krishna Sarkar Krishnendu Chakraborty Dilip Saha Paresh Banerjee Department of Cardiovascular & Thoracic Surgery Nil Ratan Sircar Medical College & Hospital Kolkata India

Background: aortico-right ventricular tunnel is an extremely rare congenital defect rarely described in an infant. This diagnosis is likely to be missed due to its rare entity and similar clinical presentations with other aortico-right ventricular communications like ruptured sinus of valsalva. Methods: We report a case of previously undiagnosed aortico-right ventricular tunnel along with a perimembraneous ventricular septal defect in an 18-year-old female. She had history of exertional dyspnoea, palpitation, history of recurrent lower respiratory tract infection. She was diagnosed as a case of ruptured sinus of valsalva (RSOV) elsewhere. She had “to and fro” murmur, features of congestive cardiac failure. Her echo diagnosis was RSOV. On surgical exploration, after opening the aorta, we found a tunnel like opening in the aorta leading to the roof of rv cavity in between right and non coronary sinuses at the commissural level. Cusps were splayed wide part. Ventricular septal defect was conspicuous from right atrial approach. Post operative CT angio was done. Results: Venricular septal defect was closed from the right atrial approach and aortico-right ventricular tunnel was repaired through aortic and right venricular approach. Postoperative CT angio also confirmed the location and closure of the defects. Postoperative recovery was uneventful. Conclusions: aortico-right ventricular tunnel in an adult female has not been reported in the literature previously. This rare entity should be considered in the differential diagnosis of a critically ill patient with a “to and fro” murmur, and signs of right heart failure.

关键词： aortico-rv Tunnel Ventricular Septal Defect

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