Aorta-right atrial tunnel: clinical presentation, diagnostic criteria, and surgical options

The Journal of Thoracic and Cardiovascular Surgery
Trushar GajjarNeelam Desai

Abstract

Aorta-right atrial tunnel is a rare and distinct congenital anomaly. To the spectrum of aorta-right atrial communications, we want to add this separate entity of aorta-right atrial tunnel by presenting the clinical features, morphologic aspects, diagnostic criteria, surgical techniques, and outcome in various clinical settings for better understanding of this developmentally intriguing, clinically complex, and therapeutically challenging disorder. From June 1994 through October 2004, 9 patients were treated for aorta-right atrial tunnel at our institution. Ages ranged from 9 to 45 years. There were 5 male subjects and 4 female subjects. Morphologically, 2 types of tunnels were identified in relationship to the ascending aorta: the anterior type in 3 patients and the posterior type in 6 patients. In all patients the diagnosis was established by means of 2-dimensional echocardiography and transesophageal echocardiography and confirmed by means of angiography. Eight patients were treated surgically, and 1 patient was treated with coil embolization. Postoperative echocardiograms obtained for all patients before discharge confirmed complete obliteration of the tunnel. One patient died perioperatively, and the other 8 patients were d...Continue Reading

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