Aortico-left ventricular tunnel with uncommon origin

A 33-year old woman presented with moderate dyspnoea on exercise. Transthoracic echocardiogram showed two eccentric jets of severe aortic regurgitation (AR). The left ventricle (LV) was dilated with preserved function (end-diastolic dimension of 58 mm and ejection fraction of 65%). Transoesophageal echocardiogram was performed, and aortico-left ventricular tunnel (ALVT) was seen …