Fig. 1

a The chest X-ray showed no significant aberrance. b-e The preoperative cardiac CTA, 3D reconstruction of cardiac CTA and echocardiography revealed an abnormal tunnel between the right posterior sinus and left ventricle. f-g Near anterolateral commissure the gap between the roots of two leaflets with a width of 0.6 cm formed into a special ostium with the inner wall of aorta when the leaflets were closed, which was sutured using 5–0 running polypropylene. h The postoperative echocardiography showed that the ALVT was turned off