Abnormal congenital aorto-cardiac communications (CACC) are a heterogeneous constellation of anomalies that provide an abnormal connection between the aorta and other cardiac chambers or structures, including the atria, ventricles, the main pulmonary artery, and the coronary sinus. The current terminology of CACC has significant errors and shortcomings including inconsistent and interchangeable use of terms of fistula and tunnel and lack of an inclusive classification with practical information on therapeutic management. The aims of this study were threefold: firstly, to perform a concise narrative review of congenital pathologic connections between the aortic root and cardiac chambers which include rupture of congenital sinus of Valsalva aneurysm, aorto-left ventricular and less commonly right ventricular tunnels, coronary cameral fistulas, and aorto-atrial communications; secondly, to investigate the differentiating features of the so-called aorta right atrial tunnel (ARAT), with and without coronary artery take-off from the tunnel, and coronary cameral fistula (CCF) by applying a differential diagnostic assistance toolbox to two groups of patients with ARAT and CCF; and lastly, to propose a practical and inclusive anatomic-therapeutic classification for CACCs. The two main cornerstones of the proposed classification are the type of the connector between the aorta and cardiac chamber (hole versus passage) and the nature of the connecting passage ( anatomic versus extra-anatomic). We classified CACCs into three types. Depending on the intramural versus extramural course of the extra-anatomic connecting passage, type 3 is further subdivided into type 3A and type 3B.

异常先天性主动脉-心脏通信 (CACC) 是一组异质性异常，可在主动脉和其他心脏腔室或结构（包括心房、心室、主肺动脉和冠状窦）之间提供异常连接。目前的 CACC 术语存在重大错误和缺点，包括对瘘管和隧道术语的不一致和可互换使用，以及缺乏具有治疗管理实用信息的包容性分类。本研究的目的有三个：首先，对主动脉根部和心腔之间的先天性病理连接进行简明的叙述性回顾，包括先天性 Valsalva 动脉瘤窦破裂、主动脉-左心室和较少见的右心室隧道、冠状动脉摄像瘘管，和主动脉心房通信；其次，通过将鉴别诊断辅助工具箱应用于两组患者，研究所谓的主动脉右心房隧道（ARAT）、有无冠状动脉从隧道引出和冠状动脉照相机瘘（CCF）的鉴别特征。 ARAT 和 CCF 患者；最后，为 CACC 提出一种实用且包容的解剖治疗分类。拟议分类的两个主要基石是主动脉和心腔之间的连接器类型（孔与通道）以及连接通道的性质（解剖与解剖外）。我们将 CACC 分为三种类型。根据解剖外连接通道的壁内与壁外过程，3型进一步细分为3A型和3B型。