Diagnosis and management of aorto-left ventricular tunnel.
Diagnosis and management of aorto-left ventricular tunnel.
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DOI：
10.4103/0974-2069.157021
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发表时间：
2015-05
影响因子：
0.7
通讯作者：
Koneti NR
中科院分区：
文献类型：
--
作者：
Kathare P;Subramanyam RG;Dash TK;Muthuswamy KS;Raghu K;Koneti NR
主动脉-左心室隧道是一种罕见的先天性心外通道，左心室进行性扩大，需要早期纠正。这是一份来自一家机构的11年来诊断和治疗急性左心室隧道（ALVT）的报告。7例患者（年龄范围：7天-45岁）出现心力衰竭。所有病例均经胸超声心动图诊断为ALVT。两名患者拒绝接受治疗，并在随访期间死亡。4例手术闭合隧道，其中1例需要Bentall手术。2例患者术后出现残余漏。在2例病例中使用Amplatzer肌肉器械进行了经导管封堵（1例用于术后残余漏，另1例用于初次手术）。其中1例发生了显著溶血，需要取出器械并手术闭合。这名儿童在两年后接受了主动脉瓣置换术。所有剩余患者在中位随访30个月（范围：1.5-9年）期间情况良好。ALVT是一种罕见且可能致命的异常，理想的治疗方法是手术。导管闭合作用有限。
Aorto-left ventricular tunnel (ALVT) is a rare congenital extracardiac channel with progressive left ventricular dilatation needs early correction. This is a report of diagnosis and management of aorto-left ventricular tunnel (ALVT) over a period of 11 years from a single institution. Seven patients (age range: 7 days-45 years) presented with heart failure. The diagnosis of ALVT was made by transthoracic echocardiogram in all cases. Treatment was refused by two patients who died during follow-up. Surgical closure of the tunnel was done in four cases, of which one needed Bentall procedure. Two patients had residual leak after the surgery. Transcatheter closure using Amplatzer muscular device was performed in two cases (for postoperative residual leak in one and primary procedure in the other). Significant hemolysis developed in one of them, necessitating the removal of the device and closed surgically. This child underwent aortic valve replacement two years later. All the remaining patients were doing well during the median follow-up of 30 months (range: 1.5-9 years). ALVT is a rare and potentially fatal anomaly that is ideally managed surgically. Catheter closure has a limited role.