Abstract
Vascular tunnels deriving from one of the aortic sinuses and flowing into the right atrium are known as aorto-right atrial tunnels. These are rare extracardiac vascular structures. Completely intracardiac tunnels are an even more rare congenital malformation. We present 2 cases exhibiting intracardiac and extracardiac aorto-right atrial tunnels. The first patient presented an intracardiac vascular structure originating from the left coronary sinus, running downward, intracavitary through the left atrium, without any communication, ending in the right atrium. The vascular structure was resected, with reconstruction of the coronary sinus and left coronary artery reimplantation. The second patient presented a vascular tunnel originating in the right coronary sinus, going between the atria and ending in the right atrium. The tunnel was resected, the right coronary sinus reconstructed, and right internal mammal artery-right coronary artery coronary artery bypass grafting was performed. We advocate for early surgical closure, even in asymptomatic patients, to avoid further complications.