EP09.39: Prenatal ultrasound of aortic left ventricular tunnel: a case report

Aortic left ventricular tunnel (ALVT), a rare heart defect affecting 0.12% of congenital heart diseases, involves underdeveloped elastic fibres in the aortic sinus leading to a tunnel between the peri-aortic valve area and the left ventricle, causing blood regurgitation. A 25-year-old G3P1 woman was referred for fetal echocardiogram at 29 weeks of gestational. No significant family history and did not take any medication. The fetal heart was normally connected. The fetal left ventricle displays spherical enlargement, wall thickening. The endocardium shows echogenic thickening. Movements of the interventricular septum and the left ventricular wall are significantly reduced and uncoordinated. The opening of the mitral valve is notably restricted, with minimal forward blood flow detected at the mitral valve orifice. Additionally, the fetus exhibits skin edema, significant abdominal fluid accumulation, placental thickening, and polyhydramnios. At the junction of the aortic sinus and the duct, a tubular echo can be observed on the anterior wall, communicating with the left ventricle with significant left ventricle to aortic flow during systole, flow reversal in diastole, diagnosed with ALVT, endomyocardial fibroelastosis and left ventricular dysfunction. Due to the patient's significant symptoms of chest tightness, asthma, and lower limb edema, coupled with fetal abnormalities and the potential for mirror syndrome, labour was induced. ALVT confirmed after autopsy. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.