Aortico–left ventricular tunnel (ALVT) is a rare congenital paravalvar communication between the aorta and the left ventricle (LV). ALVT represents an extracardiac channel that connects the ascending aorta above the sino-tubular junction to the cavity of the left ventricle. It results in chronic preload due to regurgitation leading to left ventricular (LV) dilatation and requires early surgical repair.
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