Letter to the Editor Aortico-left ventricular tunnel in adulthood: Twenty-two year follow up

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that is usually managed by surgical or catheter intervention. This case documents the 22 year follow up of a 44 year old man who has been managed medically through a programme of close clinical and echocardiographic monitoring. This report illustrates that conservative management of Type I ALVT can be undertaken without adverse clinical consequences. © 2008 Elsevier Ireland Ltd. All rights reserved.