A Case of Sinus of Valsalva-right Ventricle Fistula Without a Typical Aneurysm, and a Single Origin of the Coronary Arteries

Abstract

SUMMARYFew previous reports have described a sinus of Valsalva fistula without an aneurysm in Japanese patients. A single origin of the coronary arteries is a rare coronary anomaly. We describe a 75-year-old woman with a single origin of the coronary arteries and a sinus of Valsalva fistula without a typical aneurysm. Echocardiography showed turbulent flow from the right coronary sinus of Valsalva to the right ventricle throughout the cardiac cycle. Aortography confirmed the presence of a right coronary sinus of Valsalva-right ventricle shunt jet. Echocardiography and aortography demonstrated that there was no deformity of the sinus of Valsalva. Cardiac catheterization revealed that the left-to-right shunt rate was 29% and the Qp/Qs was 1.41. Aortography and coronary angiography did not identify a right coronary artery originating from the right sinus of Valsalva. Coronary angiography revealed that the right coronary artery arose from the proximal part of the left anterior descending artery and did not detect significant organic stenosis of the coronary artery. She was diagnosed as having a sinus of Valsalva to right ventricle fistula without an aneurysm, and a single origin of the coronary arteries. ( A sinus of Valsalva fistula without an associated aneurysm is a rare clinical lesion in Japan. [1][2][3][4][5] A single origin of the coronary arteries is a rare coronary anomaly.6,7) We describe an elderly asymptomatic patient with a single origin of the coronary arteries and a sinus of Valsalva fistula without a typical aneurysm. CASE REPORTA 75-year-old Japanese woman consulted a physician for the evaluation of an uncomfortable awareness of her heart beating. She had not had chest pain or From the

Right Sinus of Valsalva Fistula to the Right Ventricle as a Cause of Severe Heart Failure

“…Aetiopathogenesis is simple in the absence of other SV disorders. 7 In contrast, SV are related to a cardiac loop formation defect during embryonic development associated with long-lasting high pressure periods typical of the aorta. 8 The left coronary cusp is not derived from bulbar septum, and therefore, congenital left SV aneurysms do not occur.…”