Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-23T03:53:23.709Z Has data issue: false hasContentIssue false

Echocardiography of the aortopulmonary window, aorto-ventricular tunnels, and aneurysm of the sinuses of Valsalva

Published online by Cambridge University Press:  01 December 2010

William T. Mahle*
Affiliation:
Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America
Joseph Kreeger
Affiliation:
Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America
Norman H. Silverman
Affiliation:
Lucile Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, California, United States of America
*
Correspondence to: W. T. Mahle, MD, Children’s Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Road, NE, Atlanta, Georgia 30322-1062, USA. Tel: 404-315-2672; Fax: 404-325-6021; E-mail: [email protected]

Abstract

There is a collection of rare congenital cardiac defects that can produce significant haemodynamic embarrassment. Owing to their rarity, these lesions may be overlooked or mistaken for other more common congenital cardiac defects. Using careful segmental echocardiographic techniques, such as multiple planes of imaging and inferential Doppler findings, it is possible to identify these lesions and thus plan surgical management. Some of the lesions of importance reviewed include the aortopulmonary window, the aorto-ventricular tunnels, the aorto-atrial tunnels, and aneurysm of the sinuses of Valsalva. Some conditions such as the aortopulmonary window and aneurysm of the sinuses of Valsalva often occur in the setting of other congenital cardiac lesions. At times, the presence of coexisting lesions may mask some of the characteristic features of these defects. With prompt identification, all of these rare conditions are amenable to complete surgical repair. Newer modalities such as three-dimensional echocardiography can further enhance surgical planning.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kiran, VS, Singh, MK, Shah, S, John, C, Maheshwari, S. Lessons learned from a series of patients with missed aortopulmonary windows. Cardiol Young 2008; 18: 480484.g.CrossRefGoogle ScholarPubMed
2.van Son, JA, Puga, FJ, Danielson, GK, et al. Aortopulmonary window: factors associated with early and late success after surgical treatment. Mayo Clin Proc 1993; 68: 128133.CrossRefGoogle ScholarPubMed
3.Alboliras, ET, Chin, AJ, Barber, G, Helton, JG, Pigott, JD. Detection of aortopulmonary window by pulsed and color Doppler echocardiography. Am Heart J 1988; 115: 900902.CrossRefGoogle ScholarPubMed
4.Rice, MJ, Seward, JB, Hagler, DJ, Mair, DD, Tajik, AJ. Visualization of aortopulmonary window by two-dimensional echocardiography. Mayo Clin Proc 1982; 57: 482487.Google ScholarPubMed
5.Horimi, H, Hasegawa, T, Shiraishi, H, Endo, H, Yanagisawa, M. Detection of aortopulmonary window with ventricular septal defect by Doppler color flow imaging. Chest 1992; 101: 280281.CrossRefGoogle ScholarPubMed
6.Singh, A, Mehmood, F, Romp, RL, Nanda, NC, Mallavarapu, RK. Live/real time three-dimensional transthoracic echocardiographic assessment of aortopulmonary window. Echocardiography 2008; 25: 9699.CrossRefGoogle ScholarPubMed
7.Jureidini, SB, de, MD, Nouri, S, Kanter, K. Aortico-right ventricular tunnel and critical pulmonary stenosis: diagnosis by two-dimensional and Doppler echocardiography and angiography. Pediatr Cardiol 1989; 10: 99103.CrossRefGoogle ScholarPubMed
8.Cooley, RN, Harris, LC, Rodin, AE. Abnormal communication between the aorta and left ventricle: aortico-left ventricular tunnel. Circulation 1965; 31: 564571.CrossRefGoogle ScholarPubMed
9.Perez-Martinez, V, Quero, M, Castro, C, Moreno, F, Brito, JM, Merino, G. Aortico-left ventricular tunnel. A clinical and pathologic review of this uncommon entity. Am Heart J 1973; 85: 237245.CrossRefGoogle ScholarPubMed
10.Wu, JR, Huang, TY, Chen, YF, Lin, YT, Roan, HR. Aortico-left ventricular tunnel: two-dimensional echocardiographic and angiocardiographic features. Am Heart J 1989; 117: 697699.CrossRefGoogle ScholarPubMed
11.Rosenberg, H, Williams, WG, Trusler, GA, et al. Congenital aortico-right atrial communications. The dilemma of differentiation from coronary-cameral fistula. J Thorac Cardiovasc Surg 1986; 91: 841847.CrossRefGoogle ScholarPubMed
12.Kursaklioglu, H, Iyisoy, A, Celik, T, Kose, S, Amasyali, B, Isik, E. Aortico-right atrial tunnel in an adult patient. Int J Cardiovasc Imaging 2005; 21: 383385.CrossRefGoogle Scholar
13.Bharati, S, Lev, M, Cassels, DE. Aortico-right ventricular tunnel. Chest 1973; 63: 198202.CrossRefGoogle ScholarPubMed
14.Vargas, FJ, Molina, A, Martinez, JC, Ranzini, ME, Vazquez, JC. Aortico-right ventricular tunnel. Ann Thorac Surg 1998; 66: 17931795.CrossRefGoogle ScholarPubMed
15.Nakamura, K, Suzuki, S, Satomi, G. Detection of ruptured aneurysm of sinus of Valsalva by contrast two-dimensional echocardiography. Br Heart J 1981; 45: 219221.CrossRefGoogle ScholarPubMed
16.Lewis, BS, Agathangelou, NE. Echocardiographic diagnosis of unruptured sinus of Valsalva aneurysm. Am Heart J 1984; 107: 10251027.CrossRefGoogle ScholarPubMed
17.Hands, ME, Lloyd, BL, Hung, J. Cross-sectional echocardiographic diagnosis of unruptured right sinus of Valsalva aneurysm dissecting into the interventricular septum. Int J Cardiol 1985; 9: 380383.CrossRefGoogle ScholarPubMed