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14-12-2017 | Image Puzzle - Answer | Uitgave 1/2018 Open Access

Netherlands Heart Journal 1/2018

Total eclipse in the heart

Tijdschrift:
Netherlands Heart Journal > Uitgave 1/2018
Auteur:
R. J. de Winter

Answer

Aorto-right atrial tunnel (ARAT)

The entrance of the tunnel arises from one of the coronary cusps of the aorta. Because this structure may arise from the non-coronary cusp, this is not considered to be a coronary fistula [ 1]. The tunnel connects with the right atrium. Closing the ARAT with vascular plugs is achieved as follows: The entrance of the tunnel is visualised from the aorta. A wire is passed down and snared in the right atrium or superior caval vein and a body loop is formed. Careful positioning of a delivery sheath from the venous side into the tunnel is performed, without traction on the entrance of the tunnel or the aorta. Large size vascular plugs are often needed.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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