Hemodynamic compromise (tricuspid stenosis and insufficiency) caused by an unruptured aneurysm of the sinus of Valsalva

Gibbs, Kenneth L.; Reardon, Michael J.; Strickman, Neil E.; Castro, Carlos M. de; Gerard, Joseph A.; Rycyna, James L.; Hall, Robert J.; Cooley, Denton A.

doi:10.1016/s0735-1097(86)80242-x

Cited by 20 publications

(7 citation statements)

References 17 publications

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“…In our case, sinus of Valsalva aneurysm presented as a right atrial mass causing obstruction to tricuspid flow leading to right heart failure. Although, Gibbs et al 5 has reported a sinus of Valsalva with aneurysm causing right heart failure, but that was due to the presence of tricuspid stenosis, tricuspid regurgitation, but in contrast, our case had predominantly tricuspid stenosis with no tricuspid regurgitation leading to right heart failure.…”

Section: Discussion Of Managementcontrasting

confidence: 62%

A Rare Case of Sinus of Valsalva Aneurysm Presenting With Tricuspid Stenosis and Right Heart Failure

Sarma¹,

Adilakshmi²

2017

jebmh

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Section: Discussion Of Managementcontrasting

confidence: 62%

A Rare Case of Sinus of Valsalva Aneurysm Presenting With Tricuspid Stenosis and Right Heart Failure

Sarma¹,

Adilakshmi²

2017

jebmh

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“…The most notable presenting feature of ruptured sinus aneurysm is congestive heart failure with a left to right shunt [5]. The most common clinical signs are dyspnea, pulmonary edema, with continuous murmur.…”

Section: Discussionmentioning

confidence: 99%

Surgical Repair of a Sinus of Valsalva Aneurysm Ruptured into the Right Atrium Diagnosed After a Non-Penetrating Chest Trauma

Hela¹

2016

ETS

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Aorto-right atrial fistulas are lesions that result in heart failure if they are untreated. They result from rupture of congenital or acquired aortic aneurysms into the right atrium.We report an unusual case of fistula from aneurysmal right sinus of Valsalva to the right atrium discovered after a non-penetrating trauma and treated surgically. Case PresentationA 37 year-old-man, with no past medical history, was a victim of a closed chest trauma by falling in a hole whose depth was 20 meters. He was admitted to the emergency department with stable vital signs. He had mandibular fractures. Cerebral CT scan showed no anomalies. Systolic blood pressure was 131 mm Hg, diastolic blood pressure was 40 mm Hg. The patient had dyspnea. There was an ecchymosis on the chest wall. A thrill was appreciated over the precordium.Heart auscultation revealed a continuous murmur on the aortic site. A chest roentgenogram revealed an increased cardiac silhouette with bilateral alveolar opacities. There was a sinus tachycardia on the electrocardiogram, without ischemic signs or conduction disorders. A two-dimensional echocardiography revealed an important left to right shunt with a continuous flow from the aorta to the right atrium, with an aneurysm of the right sinus of Valsalva. The aneurysm was next to the right coronary artery. The aortic valve was without anomalies, and the right heart chambers were dilated. The echocardiography showed no other congenital heart diseases.Thoracic CT scan detected a bilateral pulmonary edema with a mild pleural effusion. So, the patient underwent emergent surgical repair. A median sternotomy was performed. The pericardium was opened. A continuous thrill along the aorta was palpated.Cardiopulmonary bypass was established between the aorta and two vena cavae. The intra-operative examination didn't find any hematoma around the sinus of Valsalva which was dilated. A fistula between the right sinus of Valsalva and the right atrium at the level of the right coronary artery was observed through a transverse aortotomy. This defect had 2 cm of diameter. There was no injury of the aortic valve. The defect was closed with a synthetic patch sutured with pledgeted sutures from inside the right coronary sinus at the level of the right coronary artery into the atrial wall (Figure 1).After surgery, the patient's recovery was uneventful and the patient was discharged on the fifth postoperative day. The patient remains asymptomatic and without murmurs 2 months after the surgery. DiscussionAneurysmal dilatation of the sinus of Valsalva is a cardiac anomaly caused by infective endocarditis, syphilitic aortitis, atherosclerosis, connective tissue disease or as a congenital abnormality discovered incidentally [1,2].Rupture of sinus of Valsalva aneurysm into the cardiac chambers is a complication which predominantly affects males [3,4]. When In this case report, we describe a case of a ruptured aneurysm of the sinus of Valsalva ruptured into the right atrium discovered incidentally after a non-penetrating chest trauma in...

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“…The unruptured aneurysms may go unnoticed for years, without any significant haemodynamic disturbance [1]. They may present with signs of right heart failure and a loud pulmonary flow murmur [2][3][4][5][6][7][8][9][10] or with a complete heart block caused by compression of the ventricular septum by the aneurysm [11,12]. Patients may rarely present with myocardial ischaemia, caused by coronary artery compression [10,13,14] or with dysphagia caused by oesophageal compression [15].…”

Section: Discussionmentioning

confidence: 99%

Large, unruptured, non-coronary sinus of Valsalva aneurysm

Mahmood

Wojciuk²,

Bury³

et al. 2007

Journal of Cardiovascular Medicine

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We report the case of a 73-year-old previously fit man who presented with a 10-month history of worsening dyspnoea on exertion. Transthoracic echocardiography showed a mass in the right ventricle. The diagnosis of non-coronary sinus of Valsalva aneurysm was confirmed by cardiac magnetic resonance imaging. The patient underwent surgical removal of the aneurysm with uneventful recovery. Since this rare anomaly may arise from different aetiological backgrounds, it is important to consider this condition in the differential diagnosis and diagnostic process in order to deliver prompt, and potentially life-saving, treatment.

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Hemodynamic compromise (tricuspid stenosis and insufficiency) caused by an unruptured aneurysm of the sinus of Valsalva

Cited by 20 publications

References 17 publications

A Rare Case of Sinus of Valsalva Aneurysm Presenting With Tricuspid Stenosis and Right Heart Failure

A Rare Case of Sinus of Valsalva Aneurysm Presenting With Tricuspid Stenosis and Right Heart Failure

Surgical Repair of a Sinus of Valsalva Aneurysm Ruptured into the Right Atrium Diagnosed After a Non-Penetrating Chest Trauma

Large, unruptured, non-coronary sinus of Valsalva aneurysm

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