Rare case of aorto-left atrial tunnel with associated bicuspid aortic valve, large patent ductus arteriosus, and atrial septal defects.

Aorto-cardiac tunnels represent uncommon cardiovascular anomalies connecting the ascending aorta to cardiac chambers and are typically characterized by extra-cardiac tubular channels. Among these, the involvement of the left atrium is exceptionally rare, with only a few cases reported in literature. Here, we describe a case of an aorto-left atrial tunnel in a 6-year-old boy with an associated bicuspid aortic valve, a large patent ductus arteriosus, and atrial septal defects. This case highlights the significance of multimodal imaging in the accurate identification and characterization of rare cardiovascular anomalies.