Congenital Sinus of Valsalva Aneurysm and Aortico-Left Ventricular Tunnel

Nemours Cardiac Center at Nemours/Alfred I. duPont Hospital for Children

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Children’s heart conditions can’t be prevented, but a lot can be done to improve and often completely repair their hearts at any age. Thanks to advanced technology and the pediatric heart experts at the Nemours Cardiac Center (based at Nemours/Alfred I. duPont Hospital for Children), most children born with a heart problem — even newborns only hours or days old — can be quickly diagnosed and treated right when it matters the most. At the Cardiac Center, we specialize in early detection and repair of congenital heart defects (also often called, “congenital heart disease”).

If your child’s been diagnosed with congenital sinus of Valsalva aneurysm/aortico-left ventricular tunnel, we’re here to ease your concerns, answer your questions, and give your child the best possible chance for a healthy future.

What Is It?

If your child’s been diagnosed with congenital sinus of Valsalva aneurysm and aortico-left ventricular tunnel, we’re here to ease your concerns, answer your questions, and give your child the best possible chance for a healthy future.

A congenital (meaning “present at birth”) sinus of Valsalva aneurysm happens when the wall of the one of these sinuses becomes extremely thin. Because the very bottom of the aortic root borders the left ventricle, as the sinus becomes thin and bulges out under the pressure of the aorta, it bulges in to the left ventricle. Eventually, if left untreated, the wall can become so thin that a hole forms in it, which allows blood to flow backward from the aortic root into the left ventricle (this is called an “aortico-left ventricular tunnel”).

How Does the Heart Normally Work?

When your child has a congenital heart defect, there’s usually something wrong with the structure of the heart. In order to understand your child’s condition, it can help to know how the heart should work normally.
Learn More About Normal Cardiac Anatomy »

Nemours’ experts at also offer these helpful resources to help both you and your child understand how the heart works:

How & When Is It Diagnosed?

Congenital sinus of Valsalva aneurysms are often asymptomatic (that means there are no symptoms), but they may be discovered during an echocardiogram (“echo”) done for other reasons. When a tunnel occurs, symptoms will depend on the size of the hole. If there’s only a small hole, caregivers may hear a murmur, but the child will likely be asymptomatic.

If it’s a large hole, symptoms of heart failure may develop.

Depending on the age of the child, these signs might include:
  • poor feeding
  • rapid breathing
  • fast heart rate
  • becoming easily tired

An echo is usually sufficient to make the diagnosis. This completely safe and painless test uses ultrasound (sound waves) to build a series of pictures of the heart.

How & When Is It Treated?
Depending on the size and exact location, these defects may be treated with either:
  • a cardiac catheterization procedure, which involves using a synthetic device that plugs the hole. A Nemours Cardiac Center cardiac catheterization physician will introduce the device through a heart catheter, which is passed through an artery in the leg that leads up to the heart.
  • surgical repair, if the catheter approach isn’t appropriate, a heart surgeon performs open-heart surgery — identifying the hole and sewing a patch over the top to close it. The patch material may be a portion of the child’s own pericardium (the sac around the heart) or a synthetic material.

Learn More
How Will It Affect My Child Long Term?

Following repair, most children won’t need any further surgical procedures. Occasionally, though, children may need procedures to repair the aortic valve (which is held up by the sinuses of Valsalva and may be damaged either by the aneurysm itself or by the repair procedure).

If your child has congenital sinus of Valsalva aneurysm and aortico-left ventricular tunnel, know that at the Nemours Cardiac Center we’re here to give your child the very best, most comprehensive and compassionate care. Our goal is to guide your family, from start to finish, through your child’s heart defect journey — and to help your child live the healthiest, most fulfilling life possible.

Learn More About Congenital Heart Defects »

Why Choose Us

From our outcomes to our family-centered care, find out all of the reasons why your child’s heart will be in good hands at the Nemours Cardiac Center. Learn More »

Make an Appointment

(800) 416-4441

Insurance We Accept »

Information for Patients

Outpatient Services and Inpatient Units: (302) 651-6660

After 5 p.m. and Weekends:

Cardiac Intensive Care Unit: (302) 651-6644
General Inpatient Unit, 2B: (302) 651-6690


+1 (302) 651-4993

Stories From the Heart

Meet children treated in the Nemours Cardiac Center who know what it’s like to live with a heart problem.

Read Their Inspiring Stories »