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The Annals of Thoracic Surgery, Vol 42, 304-306, Copyright © 1986 by The Society of Thoracic Surgeons

ARTICLES

Aortico-left ventricular tunnel: late follow-up

W Meldrum-Hanna, R Schroff and DN Ross

Since 1970, 6 patients have undergone repair of aortico-left ventricular tunnel. Four (67%) had repair in childhood. The technique of closure was by direct suture (5 patients) or patch closure (1 patient). Associated anomalies were seen in 5 patients (83%); absent right coronary ostium (1), commissural fusion (stenosis) (2), valvular regurgitation (3), leaflet defects (2), and healed endocarditis (1). All patients survived operation. At early postoperative review, 67% had mild aortic regurgitation regardless of the technique of surgical repair. Late follow-up revealed that 3 patients (50%) underwent aortic valve replacement (AVR) for progressive aortic regurgitation at a mean of 10 years following initial operation. A review of the literature and our results lead us to conclude that progressive aortic regurgitation is common; it is due to associated valve abnormalities and changes in the valve mechanism secondary to the aortico-left ventricular tunnel. Long-term clinical follow-up is necessary, since 50% of patients will require AVR eventually. Early operation is indicated not only to prevent heart failure but also to prevent progression of damage to the aortic valve.

This article has been cited by other articles:

				J. D. Martins, M. C. Sherwood, J. E. Mayer Jr, and J. F. Keane Aortico-left ventricular tunnel: 35-year experience J. Am. Coll. Cardiol., July 21, 2004; 44(2): 446 - 450. [Abstract] [Full Text] [PDF]

				J. L. Myers and S. M. Mehta Congenital Heart Surgery Nomenclature and Database Project: aortico-left ventricular tunnel Ann. Thorac. Surg., April 1, 2000; 69(4): S164 - 169. [Abstract] [Full Text] [PDF]