Aneurysms of sinus of Valsalva eroding into the interventricular septum: etiopathology and surgical considerations

Abstract

Unruptured aneurysm of the sinus of Valsalva eroding into the interventricular septum should be operated at the earliest, which makes surgery simple and prevents development of complications such as aortic regurgitation and heart block.

Aneurysm of Sinus of Valsalva Dissecting Into the Interventricular Septum After Aortic Valve Replacement: Diagnosis by Echocardiography and Magnetic Resonance Imaging and Treatment With Surgical Sealant

“…Acquired ASVs are caused by conditions affecting the aortic wall, such as infections (bacterial endocarditis, syphilis, or tuberculosis); chest trauma; or degenerative diseases (atherosclerosis, connective tissue diseases, or cystic medical necrosis) 3)4)11-14). Complications of ASV include arrhythmia, atrioventricular block, obstruction of ventricular outflow tract, aortic insufficiency, congestive heart failure, and multidirectional rupture with embolic event, with the most common complication being atrioventricular conduction disturbance among the reported cases 5)6)13)18)19). Dissection of the interventricular septum is a very rare complication of sinus of Valsalva aneurysm, in which case the interventricular septum is dissected and forms an aneurysm which bulges into both the left and right ventricles, causing obstruction of both ventricular outflow tracts 4).…”

“…The ASV compresses the coronary arteries leading to ventricular septal ischemia 15). Other potential causes include intraseptal rupture of ASV and/or hematoma formation 2)13). In this case, the cause of aneurysm formation with dissection into the interventricular septum is presumed to be the postoperative shear stress due to turbulent flow against the weak tissue between the interventricular septum and the prosthetic aortic valve.…”

Right Coronary Sinus of Valsalva Aneurysm With Rupture Into the Right Ventricle

“…[2][3][4] Determination of the specific etiology of SVA may be difficult and various pathologic processes may affect the development. Atherosclerotic degenerative processes or traumatic or infective .…”

Aneurisma luético de arco aórtico roto, complicado pela oclusão de vasos braquiocefálicos e acidente vascular encefálico isquêmico: relato de caso tratado cirurgicamente

“…A insuficiência valvar aórtica é geralmente secundária à dilatação anular causada pelo aneurisma aórtico, não sendo freqüente o comprometimento direto das válvulas pela doença (8) . Outras formas mais raras de comprometimento cardiovascular da doença são: os aneurismas do seio de Valsalva, dos vasos braquiocefálicos, das artérias coronárias, a dissecção aórtica e a fístula aorto-pulmonar (9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . O caso relatado apresentava um aneurisma exclusivo do arco aórtico, sem sinais inflamatórios evidentes ou calcificação macroscópica dos demais segmentos da aorta, apesar da positividade dos achados anatomopatológicos nestas porções.…”