Author + information
- Received September 4, 2009
- Accepted October 5, 2009
- Published online August 3, 2010.
- Athanasios Bratsas, MD⁎,†,
- Charalambos Vlachopoulos, MD⁎,
- Grigoris Kotoulas, MD‡,
- Thomas Makris, MD† and
- Christodoulos Stefanadis, MD⁎
A previously asymptomatic 31-year-old woman presented with dyspnea on exertion. After findings on transthoracic echocardiography of a dilated artery originating from the left coronary sinus (arrow, A)and an abnormal flow at the base of the right ventricle (RV) (arrows, B, Online Video 1), cardiac magnetic resonance imaging confirmed the suspected diagnosis of a large aortic right ventricular tunnel (ARVT) arising from the ascending aorta (Ao) (arrow, C), moving along the left atrioventricular and then mid-ventricular grooves, and ending in the base of the RV (arrows, D). Classic coronary angiography showed an anomalous origin of the left anterior descending (LAD) and left circumflex (LCX) arteries (E, Online Video 2) from the tortuous aneurysmal tunnel that was evident in its entire length with a snakelike appearance (arrow, F, Online Video 3). Computed tomography coronary angiography confirmed a very short left main coronary artery (LMCA) (G, Online Video 4) arising from the snakelike ARVT (arrow, H). The aortic right ventricular tunnel is a rare anomalous congenital extracardiac conduit and almost always is a pediatric cardiology condition.
- Received September 4, 2009.
- Accepted October 5, 2009.
- American College of Cardiology Foundation