Echocardiographic diagnosis of aortico‐left ventricular tunnel / 中华超声影像学杂志

Objective To analyze the echocardiographic features of patients with aortico‐left ventricular tunnel ( ALV T ) and explore the value of echocardiography in the diagnosis of ALV T . Methods Echocardiographic features of 23 patients with ALV T w ho were admitted to Fuwai Hospital from July 2002 to February 2019 were reviewed and analyzed . T he accuracy of echocardiographic diagnosis of ALVT was investigated by comparing the results of echocardiographic diagnosis with intraoperative and cardiac catheterization and CT . T he diagnosis methodology was summarized . T he reasons for misdiagnosis by echocardiography were analyzed . Results Among the 23 patients with ALVT , 1 case was diagnosed through CT examination prior to the operation and died from the cardiac arrest , 1 case was diagnosed through cardiac catheterization and ventriculography , the remaining 21 patients ( 91 .3% ) received the surgical operation and were diagnosed as ALV T . Eighteen patients ( 78 .2% ) were accurately diagnosed by echocardiography . One case was misdiagnosed as aortic valve insufficiency ,one case was diagnosed as aortic bicuspid valve and regurgitation ,two cases misdiagnosed as aortic valve dysplasia and insufficiency ,and one case was misdiagnosed as aortic dissection . According to Hovaguimian classification : 8 cases ( 34 .8% ) were of type Ⅰ ,12 cases ( 52 .2% ) of type Ⅱ ,1 case ( 4 .3% ) of type Ⅲ ,and 2 cases ( 8 .7% ) of type Ⅳ . Different types of patients are treated with different surgical methods . Conclusions ALV T can be accurately diagnosed with echocardiography , but it needs to be differentiated from other aorta to left ventricular shunt or reflux diseases . The establishment of the optimal diagnosis process is helpful to avoid and reduce the missed diagnosis and misdiagnosis to the greatest extent ,and provides a reliable basis for the selection of surgical methods .

Value of echocardiography in the diagnosis of aortico-left ventricular tunnel / 中华超声影像学杂志

Objective To evaluate the clinical value of echocardiography in the diagnosis of aorticoleft ventricular tunnel.Methods The echocardiographic and clinical characteristics were retrospectively analyzed in 6 patients with aortico-left ventricular tunnel we reported and 147 cases that documents reported.Results Six patients were confirmed by operation.The main echocardiographic characteristics of aortico-left ventricular tunnel were as follows:An abnormal communication began in the ascending aorta above the level of the coronary arteries,bypassed the aortic valve,and terminated in the left ventricle.The color Doppler flow imaging demonstrated to-and-fro flow,with or without aortic valve involvement.According Hovaguimian and his colleagues,2 cases were type Ⅰ,2 cases were type Ⅲ,1 case was type Ⅳ,1 case was type Ⅱ (showed as recanalization).Base on all of the 153 patients that we and documents reported,the accuracy rate of ultrasound diagnosis was 79.6％,the misdiagnosis rate was 17.1％,and missed diagnosis rate was 3.3 ％.Conclusions Echocardiography is the non-invasive and sensitive tool in the diagnosis of the type of aortico-left ventricular tunnel and structure of cardiac involvement,and is the preferred method for preoperative.

Ecbocardiographyic diagnosis of aortico-left ventricular tunnel / 中华超声影像学杂志

Objective To explore the value of echocardiography on diagnosis and differential diagnosis of aortico-left ventricular tunnel(AOLVT).Methods Echocardiographic features of 9 patients with AOLVT were reviewed and analyzed.The diagnosis methodology was summarized;the reasons for missed diagnosis and misdiagnosis by echocardiography were analyzed.Results Among 9 patients with AOLVT,one was diagnosed through CT examination prior to the operation and died from the cardiac arrest.The others all received the surgical operation and were diagnosed as AOLVT.Five patients were accurately diagnosed by echocardiography prior to the operation,4 patients were misdiagnosed,in which 3 patients were diagnosed as aortic valve regurgitation,one patient was diagnosed as aortic dissecting aneurysm.The diameter of left ventricle(LV)decreased and LV ejection fraction increased distinctively for 7 operated patients(P＜0.001)in six months after operation.Only one operated patient failed to recover from the LV dysfunction and died of aortic valve perivalvular leak in two monthes.Conclusions The diagnosis of the AOLVT mainly depends on the echocardiography.By enhancing the understanding on such disease and investigating on the structure and hemodynamics will be contributive to the accurate diagnosis of echocardiography.