Transvalvular Aortico left ventricular tunnel – A rare congenital cardiac anomaly

The aortico-left ventricular tunnel is an abnormal congenital paravalvular communication between the ascending aorta and the cavity of left ventricle. Clinical picture suggests severe aortic incompetence. We report the case of a teenage male patient whose echocardiography revealed a Type III Aortico-left ventricular Tunnel with the aortic end of the tunnel originating through a fenestration in the right coronary cusp, which is not so far reported in literature. The patient had uneventful recovery after surgical patch closure of the tunnel.