AORTICO-LEFT-VENTRICULAR TUNNEL ARISING F ROM THE LEFT AORTIC SINUS -A RARE CAUSE OF CONGENITAL AORTIC-INSUFFICIENCY

Aortico-left-ventricular tunnel is a rare congenital cardiac lesion th at often results in severe aortic insufficiency in infancy. Normally, the defect appears immediately above the right coronary sinus of Valsa lva and consists of a tunnel-like connection between the aortic root a nd the left ventricle. The differential diagnosis to coronary artery f istulae and ruptured aneurysms of the sinus of Valsalva is often diffi cult. We describe a patient with an aortico-left-ventricular tunnel or iginating from the left aortic sinus. Similar findings have been descr ibed in only three case reports. Additionally, in our case there was a stenosis in the midportion of the tunnel which was connected to an in traseptal aneurysm communicating with the left ventricular chamber via a ''septal'' defect. The infant underwent successful surgical correct ion of this malformation at 1 year and 5 months of age.