Title : Transcatheter closure of aorto-left ventricular tunnel in a 25-day-old neonate
Abstract:
History and Physical Exam: A 25-day-old male neonate presented with feeding-associated fatigue, diaphoresis, and a cardiac murmur. Clinical evaluation suggested significant hemodynamic compromise, prompting further investigation.
Imaging: Echocardiography revealed left ventricular dilation, reduced ejection fraction (45%), mild mitral regurgitation, and confirmed the presence of an aorto-left ventricular tunnel (ALVT). Diagnostic angiography under general anesthesia identified an ALVT measuring 4 mm at the left ventricular orifice and 3 mm at the aortic end.
Intervention: Transcatheter closure of the ALVT was performed using a 5×4 mm Amplatzer Duct Occluder II (ADO II) device. Initial device selection was modified due to aortic valve interaction. Post-procedural evaluation confirmed appropriate device placement with minimal residual shunting and preserved aortic valve function. The patient showed improvement in left ventricular ejection fraction to 50% and was discharged on aspirin with scheduled follow-ups.
