Left sinus of valsalva aneurysm ruptured into left ventricle

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Rationale:

Ruptured aneurysm originating from the left coronary sinus of Valsalva into the left ventricle (LV) is extremely rare. Imaging features of sinus aneurysm has been commonly reported using echocardiography or angiography. Here, we report multidetector computed tomography (MDCT) findings of left sinus of Valsalva aneurysm extending into the LV and caused severe aortic regurgitation (AR) in a 44-year-old male with latent infective endocarditis. The role of MDCT in preoperative surgical planning was also emphasized.

Patient concerns:

The patient visited our hospital due to worsening exertional dyspnea for 3 months.

Diagnoses:

On cardiac computed tomography (CT) using 320-MDCT, a saccular aneurysm arising from the left coronary sinus of Valsalva extending into the LV was diagnosed as the cause of severe AR.

Interventions:

The patient underwent resection of the aneurysm, aortic root reconstruction, and aortic valve replacement.

Outcomes:

The patient made an uneventful recovery. Follow-up echocardiography showed no paravalvular leakage with improved LV function.

Lessons:

MDCT with wide coverage and high temporal resolution can provide exact and comprehensive information about complicated conditions, leading to confident surgical planning and successful management.

Related collections

Most cited references 11

Record: found
Abstract: found
Article: not found

Sinus of Valsalva aneurysms--47 years of a single center experience and systematic overview of published reports.

G. Adam, Sherif Moustafa, Leslie Cooper … (2007)

A retrospective study was undertaken to review demographic data, clinical presentation, outcomes, and long-term results of surgical repair of sinus of Valsalva aneurysms (SVAs). SVAs are a rare anomaly. Surgery is the treatment of choice. A retrospective review of an institutional database identified 86 patients who underwent SVA repair from 1956 to 2003. Follow-up ranged from 3 months to 40 years. The median age was 45 years (range 5 to 80). Approximately 44% of the patients had associated aortic regurgitation. Ruptures occurred in 34% of patients. The predominant fistula was from the right sinus of Valsalva to the right ventricle. Most (65%) were diagnosed by echocardiography, and the remaining (35%) were diagnosed on cardiac catheterization. All subjects underwent SVA repair. Seventy-two patients (84%) underwent other cardiac procedures at the time of aneurysm repair. Six patients (7%) died perioperatively, and the actuarial 10-year survival rate was 63%. In conclusion, echocardiography is the most frequently used diagnostic tool. The most common site of the aneurysm was the right coronary sinus. The concomitant surgical repair of associated ventricular septal defect, atrial septal defect, and the aortic valve is often required. Elective surgical repair can be performed with low risk.

0 comments Cited 61 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Aneurysms of the Sinuses of Valsalva

Dmitriy N Feldman, Mary Roman (2006)

Sinus of Valsalva aneurysms are rare cardiac anomalies which may be acquired or congenital, most commonly involving the right or noncoronary sinuses. The congenital aneurysms are more common and often caused by weakness at the junction of the aortic media and the annulus fibrosus. Acquired aneurysms are caused by conditions affecting the aortic wall, such as infections (syphilis, bacterial endocarditis, or tuberculosis), trauma, or connective tissue disorders. Unruptured aneurysms are usually found incidentally during diagnostic studies. More commonly, sinus of Valsalvaaneurysms are diagnosed after clinical sequelae of rupture. Diagnosis of sinus of Valsalva aneurysm is facilitated by echocardiography, contrast aortography, and more recently, magnetic resonance imaging. Repair is generally required for ruptured aneurysms; unruptured aneurysms encroaching on nearby structures, causing myocardial ischemia, or having the potential to rupture warrant repair. A review of the literature is presented focusing on anatomy, clinical presentation of ruptured and unruptured aneurysms, noninvasive diagnostic modalities, and techniques for repair of this anomaly.

0 comments Cited 53 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm.

Anneke van der Walt, T Orszulak, Thomas W D Edwards … (1994)

Because not much is known about the longterm results of surgical treatment of ruptured sinus of Valsalva aneurysm (RSVA), we reviewed our entire 37-year experience with this condition. From August 1956 through September 1993, 31 patients aged 3 to 54 years (median age, 29 years) underwent surgical correction of RSVA. Aneurysms originated in the right (n = 24) and noncoronary (n = 7) sinuses and entered the right ventricle in 21 patients and the right atrium in 10. Coexistence cardiac lesions included ventricular septal defect (VSD) (n = 16, 15 of which were subarterial) and aortic valve insufficiency (n = 13). There was a highly significant correlation between aortic insufficiency and the presence of an associated subarterial VSD (P < .0001). There was no hospital mortality. One patient (3.2%) died of endocarditis 9 years after subsequent aortic valve replacement; overall survival was 95% at 20 years. Two foreign patients were lost to follow-up after 11 and 13 years, respectively. Follow-up in the remaining 28 survivors extended to 37 years (mean, 25.7 years). Five patients (16.1%) underwent reoperation for aortic valve replacement (n = 3), closure of recurrent fistula (n = 1), and closure of both recurrent fistula and recurrent VSD (n = 1); all had their primary operation before 1976. All patients who had reoperation had right sinus of Valsalva-to-right ventricle fistulas, and 4 had an additional subarterial VSD. Risk of reoperation was higher with right ventricle fistulas than with right atrium fistulas, and this approached statistical significance (P = .06). Risk of reoperation in patients with right ventricle fistulas was lower when an aortotomy (with or without right ventriculotomy) was used during repair (1 of 8, 12.5%) versus right ventriculotomy only (4 of 13, 30.8%), although this did not reach statistical significance (P = .10). Need for reoperation was increased with the presence of a subarterial VSD (P = .08) but not with location of fistula or type of repair (direct suture versus patch). Of 9 patients with mild aortic insufficiency at primary operation, two developed late severe aortic insufficiency necessitating aortic valve replacement at 21 and 31 years, respectively. Twenty-five patients are in New York Heart Association class I, and 3 are in class II. Long-term survival after surgical treatment of RSVA is excellent. The risk for recurrent fistula or VSD is minimal in the current era. Late aortic insufficiency is still a risk, especially in right sinus of Valsalva-to-right ventricle fistula with associated subarterial VSD. Repair of RSVA through an aortotomy with or without cardiotomy permits inspection of the aortic root complex and facilitates aortic valve repair; this approach may reduce the incidence of late aortic insufficiency.

0 comments Cited 15 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: June 2017

Publication date (Electronic): 08 June 2017

Volume: 96

Issue: 23

Electronic Location Identifier: e7112

Affiliations

[a ]Department of Radiology, Gyeongsang National University School of Medicine, Institute of Health Sciences, Jinju, and Gyeongsang National University Changwon Hospital, Changwon

[b ]Department of Pathology

[c ]Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.

Author notes

[∗ ]Correspondence: Kyung Nyeo Jeon, Department of Radiology, Gyeongsang National University School of Medicine, Jinju, and Gyeongsang National University Changwon Hospital, 555 Samjeongja-dong, Seongsan-gu, Changwon 51472, Korea (e-mail: knjeon@ 123456gnu.ac.kr ).

Article

Publisher ID: MD-D-17-00984 Accession ID: 07112

DOI: 10.1097/MD.0000000000007112

PMC ID: 5466237

PubMed ID: 28591059

SO-VID: 533c1bdc-156c-4db0-8426-0387241bd3bb

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

History

Date received : 16 February 2017

Date revision received : 3 April 2017

Date accepted : 15 May 2017

Custom metadata

OPEN-ACCESS TRUE

Keywords: aortic regurgitation,infective endocarditis,left sinus of valsalva aneurysm,left ventricle,mdct

Data availability:

Keywords: aortic regurgitation, infective endocarditis, left sinus of valsalva aneurysm, left ventricle, mdct

Left sinus of valsalva aneurysm ruptured into left ventricle : A case report of 320-multidetector CT findings

Read this article at

Abstract

Rationale:

Patient concerns:

Diagnoses:

Interventions:

Outcomes:

Lessons:

Related collections

Network Medicine

Most cited references 11

Sinus of Valsalva aneurysms--47 years of a single center experience and systematic overview of published reports.

Aneurysms of the Sinuses of Valsalva

Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 365

Cited by 2

Most referenced authors 109