Ruptured aneurysm of the sinus of Valsalva

Aneurysm of the sinus of Valsalva is a rare cardiac disease. It is usually an asymptomatic anomaly, however when it ruptures, symptoms appear and patient's condition deteriorates rapidly. We describe a case of a 24-year female with a ruptured aneurysm of the non-coronary sinus of Valsalva. The aneurysm ruptured in the right atrium causing severe hemodynamic complications. The diagnosis was made by transthoracic and transesophageal echocardiography.     

Ruptured sinus of Valsalva aneurysm with aortic-left atrial fistula.

We report the case of a previously healthy 56-year-old male who suddenly developed severe chest pain and pulmonary edema. Cardiac catheterization and angiography revealed an aneurysm of the noncoronary sinus of Valsalva which had ruptured into the left atrium. This was confirmed at operation and it was noted that there were no signs of bacterial infection or rheumatic valve disease. We therefore concluded that the aneurysm was of congential origin. A successful repair of the defect was carried out and the patient made a satisfactory recovery. There are only 3 other reported cases of rupture of a congenital sinus of Valsalva aneurysm into the left atrium, and in only one case did the aneurysm originate from the noncoronary sinus and this patient had associated rheumatic aortic and mitral valve disease. We have received the classification of sinus of Valsalva aneurysms, the associated congenital and acquired defects and the presenting features of unruptured and ruptured aneurysms.     

Ruptured aneurysm of the sinus of Valsalva in association with persistent left superior vena cava--a case report

A 58-year-old man presenting with chest pain and dyspnea was diagnosed by transesophageal echocardiography and cardiac catheterization to have the rare combination of ruptured aneurysm of noncoronary sinus of Valsalva into the right ventricle in association with persistent left superior vena cava. These defects were confirmed at cardiac surgery. This case shows the importance of complementary use of invasive and noninvasive methods together in the diagnosis of rare combinations of lesions.     

Ruptured sinus of Valsalva aneurysm with dynamic aortic regurgitation

The ruptured sinus of Valsalva aneurysm (SVA) can present with dynamic aortic regurgitation (AR). Hemodynamic changes elicited by induction of general anesthesia can lead to dynamic AR in setting of ruptured SVA. Perioperative echocardiography is critical in understanding the etiology of AR and in guiding surgical decision-making. If the aortic valve is structurally normal, AR may resolve following patch repair of the SVA rupture defect. Conventional measures of assessing AR severity are not accurate with continuous left-to-right flow across a ruptured SVA.     

Ruptured aneurysm of the sinus of Valsalva associated with an atrial septal aneurysm

Aneurysm of the sinus of Valsalva (ASV) is a rare cardiac disease that may be acquired or congenital. It is usually an asymptomatic condition; however, when it ruptures, symptoms appear and the condition deteriorates rapidly. Atrial septal aneurysm (ASA) is a localized "saccular" deformity of the interatrial septum that is associated with cerebrovascular events of embolic origin. We will report on a case of a 69-year-old woman who was referred to our department because of congestive heart failure. Echocardiographic evaluation, both transthoracic and transesophageal, disclosed a ruptured aneurysm of the right sinus of Valsalva into the right atrium (RA), which was associated with an aneurysm of the atrial septum.     

Ruptured sinus of Valsalva aneurysm associated with noncompaction of the ventricular myocardium.

Rupture of a sinus of Valsalva aneurysm is a rare, but life-threatening cardiac abnormality that requires surgical correction when diagnosed, and is frequently associated with other congenital defects, particularly with ventricular septal defect, aortic valve regurgitation, and bicuspid aortic valve. We present the case of a 21-year-old man who had a ruptured aneurysm of the noncoronary sinus into the right atrium, a ventricular septal defect, a persistent left superior vena cava and a noncompaction of the ventricular myocardium diagnosed by two-dimensional echocardiography. Surgical repair was carried out and the patient made an uneventful recovery.     

Ruptured aneurysm of the sinus of Valsalva into the right ventricle--apropos of a case

A 37 year old man was referred to our institution because of a cardiac murmur, exertional dyspnea and fatigue, symptoms that began since 18 years of age. He reported a cardiac murmur since childhood, with no past history of rheumatic fever or infectious endocarditis. On clinic examination there was a systolic-diastolic murmur louder in the third and fourth left intercostal space, just at the sternal left border. The 2 D-echo revealed a small disruption in the aorto-septal continuity. Right heart catheterisation was performed, showing an increased pressure in the pulmonary artery and right ventricle; an increase in the oxygen saturation on the right heart chambers, suggested the presence of a left-to-right shunt, nevertheless the exact location of the defect was not possible to recognise. The study was complemented with Doppler color flow imaging that revealed a turbulent flow through the defect, with blood flowing from the aortic root into the right ventricular outflow tract. The diagnosis of ruptured aneurysm of sinus of Valsalva was made, being confirmed later by aortic angiography. A rare case is reported in which an aneurysm of the right coronary sinus ruptured into the right ventricle; we emphasize the important contribution of the Doppler color flow imaging to the correct diagnosis, technique rarely described in this type of complication.     

Ruptured aneurysm of aortic sinus of Valsalva into right ventricle.

We report a patient with ruptured aneurysm of the aortic sinus of Valsalva into the right ventricle, whose heart murmur represented only a diastolic element without aortic regurgitation. Surgery revealed a small opening through myocardium of the ventricular septum without ventricular septal defect. During systole, the opening was constricted and presumably closed with myocardial contraction, and left-to-right shunt might have occurred only in diastole. This might lead to only a diastolic murmur.     

Unruptured aneurysm of the right sinus of Valsalva: a case report

A previously healthy and asymptomatic 45-year-old woman was referred for evaluation of a heart murmur and an unusual dilatation in the aortic root. Transthoracic and transesophageal echocardiography, computed tomography, magnetic resonance imaging, and cardiac catheterization revealed an aneurysm with a maximum diameter of 6.0 cm in the right sinus of Valsalva. Aortic regurgitation and stenosis at the right ventricle outflow tract were associated with the aneurysm. Surgery and histological study demonstrated that the sinus of Valsalva aneurysm was enormously dilated with idiopathic degenerative change in the aortic media. The aneurysm was tremendously large compared to any previously reported. Decrease in pressure load during diastole caused by aortic regurgitation probably resulted in the growth of this huge aneurysm without rupture.     

Ruptured sinus of Valsalva aneurysm: 10-year Indian surgical experience

Sinus of Valsalva aneurysm is a rare anomaly with a higher incidence in Eastern than Western populations. Recent improvements in diagnostic techniques have resulted in more patients undergoing surgical repair. Uncorrected, the intracardiac shunts and frequently associated cardiac lesions cause a preventable deterioration in heart function. We retrospectively analyzed the data of 33 patients who underwent repair of ruptured sinus of Valsalva aneurysm from May 2000 to January 2010. The aneurysms originated from the right coronary sinus in 24 patients and from the noncoronary sinus in 9, and ruptured into the right ventricle in 21, right atrium in 10, and left ventricle in 2. Operative procedures included simple plication (1), patch repair (32), and aortic valve replacement (10). There were 3 early deaths. The 30 survivors were followed up for 5.4 ± 2.6 years; all had an improvement in functional class, with superior results in those with no aortic regurgitation. Surgical treatment of ruptured sinus of Valsalva aneurysm has an acceptably low operative risk and good long-term symptom-freedom survival. An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease.     

Giant extracardiac unruptured aneurysm of the sinus of Valsalva: a case report

Extracardiac unruptured aneurysm of the sinus of Valsalva (ASV) is rare and difficult to diagnose accurately by echocardiography or cardiac catheterization preoperatively. A 63-year-old woman, with dyspnea and palpitations, diagnosed with aortic regurgitation (AR) with congestive heart failure and extracardiac unruptured ASV, was referred to our hospital for surgical repair. The unruptured ASV was well visualized by magnetic resonance imaging (MRI), and diagnosed as an extracardiac type. Surgical repair was performed by aortic valve replacement and aneurysmectomy. It was concluded that early surgical repair of extracardiac ASV should be considered to prevent sudden death, and MRI is an accurate and useful method for preoperative diagnosis. Received: February 15, 2001 / Accepted: May 22, 2001     

Ruptured aneurysm of sinus of Valsalva co-existing with a single coronary artery

The clinical and surgical findings in a 41-year-old male withthe unusual co-existence of a ruptured sinus of Valsalva aneurysmand a single coronary artery are described. The literature isreviewed and the significance of a single coronary artery discussed.     

主动脉窦瘤破裂形成室间隔夹层一例

患者男性,46岁,因突发胸痛、胸闷60 min于2010年7月入院.患者无明显诱因突发心前区疼痛,伴胸闷、心悸、大汗及左上肢麻木,含服速效救心丸后症状稍缓解.患者有反复发作胸痛、气促病史1年余,多在情绪激动及劳累下发作,伴晕厥2次.2009年4月在当地医院查心电图示三度房室传导阻滞,查超声心动图示左心房增大,室壁增厚,主动脉瓣轻度反流.     

Case report: Crouzon syndrome with short stature

A five-year-old boy with Crouzon Syndrome, short stature, and delayed bone age was found to have partial growth hormone deficiency. Accelerated growth was observed after human growth hormone replacement. Children with Crouzon Syndrome should be followed closely for all growth parameters, not just head circumference.     

Ruptured sinus of Valsalva aneurysm: A reversible cause of suprasystemic pulmonary hypertension

Management of patients with congenital heart defects and associated pulmonary arterial hypertension remains a major concern. With evolving targeted drug therapies and new iterations of transcatheter devices, treatment of appropriately selected patients with severe pulmonary hypertension, classically considered inoperable, has become feasible. We report the case of a patient with concomitant ruptured right sinus of Valsalva aneurysm and ventricular septal defect, with early reversal of suprasystemic pulmonary pressures following successful percutaneous closure of ruptured sinus of Valsalva.