Abstract
Aneurysm of the sinus of Valsalva (ASV), frequently associated with ventricular septal defect (VSD), is a rare cardiac disease that may be acquired or congenital. Rupture of an ASV, rare in the noncoronary cusp, usually produces serious hemodynamic change and carries poor prognosis if not treated surgically. We present the case of a 55‐year‐old female who came to us complaining of exertional dyspnea. Transthoracic echocardiography and aortography showed a noncoronary cusp ASV with rupture into the right atrium but without VSD. Because of high left to right shunt flow, she underwent successful surgical intervention with aneurysm repair approached from both the aorta and right atrium with a knitted Dacron patch. This was a rare case of noncoronary cusp involvement in ASV that ruptured into the right atrium without VSD.
Keywords: aneurysm, sinus of Valsalva, rupture, right atrium, noncoronary cusp
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References
- 1. Sakakibara S, Konno S. Congenital aneurysm of the sinus of Valsalva: anatomy and classification. Am Heart J. 1962; 63: 405–424. [DOI] [PubMed] [Google Scholar]
- 2. Hope J. A Treatise of Diseases of the Heart and Great Vessels. 3rd edition. London: John Churchill. 1839. [Google Scholar]
- 3. Thurman J. On aneurysms and especially spontaneous varicose aneurysms of the ascending aorta and sinuses of Valsalva, with cases. Med Chir Tr (Lond). 1840; 23: 323–324. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Smith WA. Aneurysm of the sinus of Valsalva with report of two cases. JAMA. 1914; 62: 1878–1879. [Google Scholar]
- 5. Chu SH, Hung CR, How SS, et al. Ruptured aneurysms of the sinus of Valsalva in Orientals. J Thorac Cardiovasc Surg. 1990; 99: 288–298. [PubMed] [Google Scholar]
- 6. Mayer J, Wukasch DC, Hallman GL, et al. Aneurysm and fistula of the sinus of Valsalva. Clinical considerations and surgical treatment in 45 patients. Ann Thorac Surg. 1975; 19: 170–179. [DOI] [PubMed] [Google Scholar]
- 7. Abbott ME. Clinical and Developmental Study of a Case of Ruptured Aneurysm of the Right Anterior Aortic Sinus of Valsalva: Contributions to Medical and Biological Research. New York: Paul B. Hoeber. 1919, 899. [Google Scholar]
- 8. Shumacker HB Jr. Aneurysms of the aortic sinuses of Valsalva due to bacterial endocarditis, with special reference to their operative management. J Thorac Cardiovasc Surg. 1972; 63: 896–902. [PubMed] [Google Scholar]
- 9. Debakey ME, Lawrie GM. Aneurysm of sinus of Valsalva with coronary atherosclerosis: successful surgical correction. Ann Surg. 1979; 189: 303–305. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10. Bontils‐Roberts EA, DuShane JW, McGoon DC, et al. Aortic sinus fistula: surgical considerations and results of operation. Ann Thorac Surg. 1971; 12: 492–502. [DOI] [PubMed] [Google Scholar]
- 11. Nowicki ER, Aberdeen E, Friedman S, et al. Congenital left aortic sinus‐left ventricle fistula and review of aortocardiac fistulas. Ann Thorac Surg. 1977; 23: 378–388. [DOI] [PubMed] [Google Scholar]
- 12. Sakakibara S, Konno W. Congenital aneurysms of sinus of Valsalva: a clinical study. Am Heart J. 1962; 63: 708–719. [DOI] [PubMed] [Google Scholar]
- 13. Raizes GS, Smith HC, Vlietstra RE, et al. Ventricular tachycardia secondary to aneurysm of sinus of Valsalva. J Thorac Cardiovasc Surg. 1979; 78: 110–115. [PubMed] [Google Scholar]
- 14. Venning GR. Aneurysms of the sinuses of Valsalva. Am Heart J. 1951; 42: 57–63. [Google Scholar]
- 15. Morch JE, Greenwood WF. Rupture of the sinus of Valsalva: a study of eight cases with discussion on the differential diagnosis of continuous murmurs. Am J Cardiol. 1966; 18: 827–836. [DOI] [PubMed] [Google Scholar]
- 16. Falholt W, Thomsen G. Congenital aneurysm of the right sinus of Valsalva, diagnosed by aortography. Circulation. 1953; 8: 549–553. [DOI] [PubMed] [Google Scholar]
- 17. Sawyers JL, Adams JE, Scott HW Jr. Surgical treatment for aneurysms of the aortic sinuses with aortico atrial fistula: experimental and clinical study. Surgery. 1957; 41: 26–30. [PubMed] [Google Scholar]