Thorac Cardiovasc Surg 2013; 61 - P30
DOI: 10.1055/s-0033-1354519

Surgical Repair of Aortoventricular Tunnel Connected into the Apex of Right Ventricle in a Neonate

D Bobylev 1, M Ono 1, L Meschenmoser 1, A Neumann 1, D Boethig 2, H Bertram 2, A Horke 1
  • 1Klinik für Herz-, Thorax, Transplantation und Gefäßchirurgie
  • 2Klinik für Kinderkardiologie und Pädiatrische Intensivmedizin, Medizinische Hochschule Hannover

Introduction: Aortoventricular tunnel is a rare congenital malformation, which can lead to heart failure in neonates. This extra cardiac channel may connect the ascending aorta above the sinotubular junction to the cavity of the left or right ventricle. Only 17 of cases of aortoright ventricular tunnel (ARVT) have been reported in the literature.

Case Report: A 3-day-old girl with weight of 2,370 g, without any complicated antenatal history, admitted with a murmur and tachypnea since birth. Transthoracic echocardiography showed a large fistulous tunnel arising from the left coronary sinus suggesting AVRT (Fig. 1). Cardiac catheterization was done, and retrograde aortography (Fig. 2) and selective injection proximal to the orifice of the tunnel showed a tunnel length of 42 mm, width of up to 12 mm, connected into the apex of right ventricle. Immediate surgery was performed through a median sternotomy under cardiopulmonary bypass. Repair consists of closing both the ends of tunnel. The patient was extubated on POD 2 day and discharged from the hospital completely recovered.

Fig. 1

Fig. 2

Conclusion: The authors present a neonate with rare aortoright ventricle tunnel connected into the apex of right ventricle. Surgical closure of the both ends of ARVT was successfully performed.