Fistulous communication of aortic sinuses into the cardiac chambers. Fifteen years surgical experience and a report of 23 patients.

Abstract

SUMMARYOver the past 15 years 23 patients, aged 14-50, with aortic sinus-cardiac chamber fistulous communication have been operated upon. All were symptomatic and had angiographic evaluation before surgery. The last 5 were diagnosed by two-dimensional echocardiography.The origin of the fistula was the right aortic sinus in 22 and the non-coronary sinus in 1. The involved cardiac chamber was the right ventricle in 18, right atrium in 3 and left ventricle in 2. Associated lesions were ventricular septal defect (VSD) in 9, ventricular septal defect+atrial septal defect (VSD+ ASD) in 1, ventricular septal defect+pulmonary stenosis (VSD+ PS) in 1, atrial septal defect (ASD) in 3 and congenital aortic stenosis (AS) in 1. At surgery both the aorta and involved cardiac chamber were opened. No recurrence was encountered when the fistula was repaired using teflon felts on both ends. Three patients,

Percutaneous Closure of a Ruptured Sinus of Valsalva Aneurysm under Transesophageal Echocardiography Guidance

“… 1 Epidemiologic studies suggest that the incidence of congenital SOVA ranges from 0.1% to 3.5%, with a 4:1 male predominance and incidence of rupture 5 times higher in East Asian patients than in Westerners. 2 , 3 , 4 Congenital SOVA most commonly originates from the right coronary sinus (70%-80%), followed by the noncoronary sinus (20%-30%), with <5% arising from the left coronary sinus. 5 Sakakibara and Konno subsequently classified the anatomic origin of SOVA and respective protrusion sites into 5 categories known as the Sakakibara classification, which can be simplified into the following: type I, rupture into the RV just beneath the pulmonary valve; type II, rupture into or just beneath the crista supraventricularis of the RV; type III, rupture into the RA or RV near or at the tricuspid annulus; type IV, rupture into the RA; and type V, other rare conditions, such as rupture into the LV, left atrium, pericardium, or pulmonary artery.…”

Sinus of Valsalva Fistula to the Right Ventricle along with Coronary Artery Fistula to the Pulmonary Artery in a Young Native American Female

“…Congenital sinus of Valsalva aneurysms is usually undetected until they rupture, which usually occurs in the third or fourth decade of life [5]. The risk of rupture is about 0.4% [6]. Closure of an aortic right ventricular fistula in asymptomatic patients is recommended due to the low rate of procedure related complications and the risk of heart failure, bacterial endocarditis, pulmonary vascular disease, aneurysm formation, and spontaneous rupture.…”

Aorto‐Right Atrial Fistula Following Transseptal Catheterization and Catheter Ablation for Atrial Fibrillation

“…Acquired aorto‐cameral fistulas have been reported after left heart catheterization, 5 with sinus of Valsalva aneurysm, 2,10,11 after percutaneous closure of an atrial septal defect, 4 and complicating aortic dissection 1 . In 1984, Ladowski et al , described an iatrogenic aorto‐atrial fistula acquired during a left‐heart catheterization following forceful advancement of the catheter after resistance was encountered.…”