Isolated unruptured sinus of Valsalva aneurysm producing right ventricular outflow obstruction

Haraphongse, M; Ayudhya, Rapeephon Kunjara Na; Jugdutt, Bodh I.; Rossall, Richard E.

doi:10.1002/ccd.1810190208

Cited by 28 publications

(9 citation statements)

References 10 publications

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“…Some patients may present with complications of conduction abnormalities, coronary insufficiency and occlu- sion, or RVOT obstruction [1,2], as in our patient. Kiefaber et al…”

Section: Discussionmentioning

confidence: 81%

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Unruptured sinus of Valsalva aneurysm with right ventricular outflow tract obstruction associated with ventricular septal defect

Liang

Chang

Kao

1996

Cathet. Cardiovasc. Diagn.

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“…Some patients may present with complications of conduction abnormalities, coronary insufficiency and occlu- sion, or RVOT obstruction [1,2], as in our patient. Kiefaber et al…”

Section: Discussionmentioning

confidence: 81%

“…An unruptured sinus of Valsalva aneurysm (SVA) obstructing the right ventricular outflow tract (RVOT) is extremely rare [ 1,2]. All reported cases are in adults.…”

Section: Introductionmentioning

confidence: 97%

Unruptured sinus of Valsalva aneurysm with right ventricular outflow tract obstruction associated with ventricular septal defect

Liang

Chang

Kao

1996

Cathet. Cardiovasc. Diagn.

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“…Nine cases of compression of the RVOT by a sinus of Valsalva aneurysm have been reported, all of which involved the right coronary sinus of Valsalva, consistent with the aneurysm observed in our patient. More importantly, in three of these cases in which surgery for symptomatic RVOT obstruction was performed, repair of the ASV resulted in symptomatic improvement (1,4,5). Although the standard of care for a ruptured ASV entails repair of the aneurysm (6), reported experience with unruptured ASVs is limited (7).…”

Section: Discussionmentioning

confidence: 99%

Familial unruptured sinus of Valsalva aneurysm obstructing the right ventricular outflow tract

Farand

Brochu

Gervais

et al. 2009

Canadian Journal of Cardiology

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A neurysm of the coronary sinus of Valsalva (ASV) is rare. It may be congenital, sometimes in association with other cardiac defects (most commonly ventricular septal defect or coarctation), or it may be acquired. The first manifestation of ASV is most often related to rupture, whereas unruptured ASVs are rare. Although unruptured aneurysms are frequently asymptomatic without physical findings, they can be associated with complications and can compress adjacent structures. We present a case of a familial unruptured right ASV causing obstruction of the right ventricular outflow tract (RVOT) and subsequent evolution following repair. CASE PRESENTATIONA 77-year-old woman presented with stable dyspnea on exertion (New York Heart Association [NYHA] class III), which she had been experiencing for the past year. Her medical history revealed only hypothyroidism and hysterectomy with bilateral salpingooophorectomy. A transthoracic echocardiography performed five years earlier was normal except for a mild increase in peak transvalvular pulmonary velocities (1.3 m/s). Examination revealed normal blood pressure and a systolic heart murmur (grade 3/6) best heard along the left sternal border. Further examination showed distension of the jugular veins and mild ankle edema. Recorded electrocardiogram alterations were a mild Q wave with inversion of the T wave in inferior leads. Computed tomography angiography of the chest showed no pulmonary embolism but revealed moderate proximal thoracic aorta ectasia. Pulmonary function tests were normal. Controlled transthoracic echocardiography (Figure 1) showed a right ASV and RVOT obstruction with a subvalvular pulmonary systolic gradient of 45 mmHg. Left ventricular contractility was normal on echocardiography with moderate aortic regurgitation (grade 3/4). Aortic angiography (Figure 2) confirmed a right ASV while cardiac catheterization confirmed RVOT obstruction with no shunt. Coronary angiography was normal. The patient was unable to undergo magnetic resonance imaging due to claustrophobia.The decision was made to repair the aneurysm because the patient's symptoms were likely related to RVOT obstruction and there was evidence of aneurysm progression on serial echocardiography. It was also known from the pathology report that the patient's younger brother had died 24 years earlier at 48 years of age from a ruptured ASV. The ASV was repaired with a pericardial patch. The aortic valve was also replaced with a Carpentier-Edwards porcine case report ©2009 Pulsus Group Inc. All rights reserved A case demonstrating compression of the right ventricular outflow tract by an unruptured coronary sinus of Valsalva aneurysm in which repair resulted in symptomatic improvement is presented. The pathology report revealed that the patient's younger brother had died from a ruptured aneurysm of the coronary sinus of Valsalva. The present report is the first to describe a familial unruptured coronary sinus of Valsalva aneurysm raising questions regarding the screening of relatives of patients with sinus...

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“…1 However, most unruptured aneurysms of the sinus of Valsalva are silent, although several modes of presentation have been reported, including mediastinal mass, 2 RVOT obstruction, 3,4 acute myocardial infarction resulting from coronary artery obstruction, 6 arrhythmias, including atrial fibrillation, 7 ventricular tachycardia, 8 conduction disturbance 9 or sudden death, 10 and congestive heart failure resulting from aortic regurgitation. 11 A few cases have been reported as presenting with distal thromboembolism, including stroke.…”

Section: Discussionmentioning

confidence: 99%

Huge Calcified Aneurysm of the Sinus of Valsalva

et al. 2001

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Isolated unruptured sinus of Valsalva aneurysm producing right ventricular outflow obstruction

Cited by 28 publications

References 10 publications

Unruptured sinus of Valsalva aneurysm with right ventricular outflow tract obstruction associated with ventricular septal defect

Unruptured sinus of Valsalva aneurysm with right ventricular outflow tract obstruction associated with ventricular septal defect

Familial unruptured sinus of Valsalva aneurysm obstructing the right ventricular outflow tract

Huge Calcified Aneurysm of the Sinus of Valsalva

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