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

Liang, Chi-Di; Chang, Jen‐Ping; Kao, C. L.

doi:10.1002/(sici)1097-0304(199602)37:2<158::aid-ccd11>3.0.co;2-g

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…The RVOT gradient in the present case was however not significant. It is estimated that 26-50% of subjects with right sinus of Valsalva aneurysm may have an associated ventricular septal defect (8,9). The case presented had no ventricular septal defect either at echocardiography or at surgery.…”

Section: Discussionmentioning

confidence: 87%

“…The case presented had no ventricular septal defect either at echocardiography or at surgery. Usually the thrill and the associated continuous murmur of ruptured sinus of Valsalva aneurysm are said to be maximal at the lower left sternal edge (9). In the case presented, the machinery murmur was maximal at the upper left sternal edge simulating patent ductus arteriosus (PDA).…”

Section: Discussionmentioning

confidence: 93%

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Rupture of sinus of valsalva aneurysm: Case report

Amoah¹,

Frimpong-Boateng²,

Baddoo³

2009

E Af Med Jrnl

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Sinus of Valsalva aneurysms are uncommon. Aortic sinus aneurysm may be complicated by endocarditis or rupture. A 26 year old native Ghanaian presented with dyspnoea, raised jugular venous pressure (JVP), tender hepatomegaly, peripheral oedema, a thrill and a continuous murmur at the upper left sternal edge. Two-dimensional doppler echocardiography with colour flow mapping revealed a large aneurysm of the right sinus of Valsalva (4cm diameter) that abutted the right ventricular out-flow tract with distortion of the pulmonary valve. Colour flow revealed left to right shunting of blood from the aortic root into the right atrium. A year later he presented with a febrile illness, weight loss, night sweats and was diagnosed as having culture negative infective endocarditis. Following a course of antibiotics, he underwent successful cardiopulmonary bypass surgery with repair of the ruptured aneurysm of the right sinus of Valsalva.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Rupture of sinus of valsalva aneurysm: Case report

Amoah¹,

Frimpong-Boateng²,

Baddoo³

2009

E Af Med Jrnl

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“…Unruptured aneurysms of the RCC have been found to cause pulmonary insufficiency, RVOT obstruction, myocardial ischemia, conduction disturbances, and TR . A coexisting VSD has also been reported . The association between the right and noncoronary SVA and VSD has been proposed to result from incomplete fusion between the right and left distal bulbous septum .…”

Section: Discussionmentioning

confidence: 99%

Unruptured Sinus of Valsalva Aneurysm with Right Ventricular Outflow Tract Obstruction and Ventricular Septal Defect—A Rare Combination

2015

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Sinus of Valsalva aneurysms are rare cardiac anomalies that may be acquired or congenital. We describe the case of a patient who had an unruptured sinus of Valsalva aneurysm causing right ventricular outflow obstruction, with an associated subaortic ventricular septal defect. Sinus of Valsalva aneurysms rarely present until rupture occurs. However, the unruptured aneurysm of the right sinus of Valsalva caused significant right ventricular outflow tract obstruction, resulting in exertional dyspnea. Intraoperative multiplane transesophageal echocardiography and color Doppler helped in precise identification of structural anomalies, shunt location, and definitive surgical repair.

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“…Other causes of subpulmonic obstruction reported in the literature include aneurysm of the membranous septum [5,6], aneurysmal tricuspid valve tissue in the setting of membranous ventricular septal defect [7], double-chambered right ventricle [8], and unruptured sinus of Valsalva aneurysm [9,10]. A single case of right ventricular outflow tract obstruction resulting from a tuberculoma in a patient with ventricular septal defect and aneurysm of the membranous septum has also been reported [11].…”

Section: Discussionmentioning

confidence: 99%

Discrete subpulmonic membrane in association with isolated severe pulmonary valvar stenosis

Tefera

Bermúdez-Cañete

Rubio

2013

BMC Cardiovasc Disord

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BackgroundSubpulmonic membrane as a cause of right ventricular outflow tract obstruction in patients with concordant ventriculoarterial connection and intact ventricular septum is considered to be rare.Case presentationA 7 – year – old boy was referred to a tertiary care hospital with complaints of dyspnea on moderate exertion and palpitations of about 2 years duration. Physical examination revealed parasternal lift, systolic thrill and a 4/6 ejection systolic murmur, best heard over the left 2nd intercostal space. His oxygen saturation was 88% on room air. Two-dimensional echocardiography showed a thickened pulmonary valve with fused leaflets that show severe systolic doming. There was a discrete subpulmonic membrane about 1.3 cm below the pulmonary valve annulus. Continuous wave Doppler interrogation showed peak systolic pressure gradient of 185 mmHg across the pulmonary valve. Balloon dilation of the pulmonary valve was performed and the pressure gradient came down to 50 mmHg. Follow-up transthoracic echocardiography showed residual pressure gradient of about 50 – 60 mmHg across the pulmonary valve. The residual pressure gradient appeared to be mainly subvalvar, as seen on the continuous wave Doppler tracing. The patient reported marked improvement in terms of exercise tolerance and subjective symptoms.ConclusionsAssociation of subpulmonic membrane with severe pulmonary valvar stenosis, concordant ventriculoarterial connection and intact ventricular septum is rare. When it occurs, the result of percutaneous valve dilation may be suboptimal.

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

Cited by 14 publications

References 11 publications

Rupture of sinus of valsalva aneurysm: Case report

Rupture of sinus of valsalva aneurysm: Case report

Unruptured Sinus of Valsalva Aneurysm with Right Ventricular Outflow Tract Obstruction and Ventricular Septal Defect—A Rare Combination

Discrete subpulmonic membrane in association with isolated severe pulmonary valvar stenosis

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