ANEURYSM OF SINUS OF VALSALVA DISSECTING INTO THE INTERVENTRICULAR SEPTUM - ECHOCARDIOGRAPHIC DIAGNOSIS (A Case Report).
Ontology highlight
ABSTRACT:
SUBMITTER: Akhtar M
PROVIDER: S-EPMC5529686 | biostudies-other | 1994 Apr
REPOSITORIES: biostudies-other
Similar Datasets
Project description: Not available
| S-EPMC7414810 | biostudies-literature
Project description:BackgroundRuptured sinus of Valsalva (RSOV) is a rare disorder, which usually involves the right coronary sinus (RCS) or the non-coronary sinus (NCS) and ruptures usually into the right-sided chambers. Involvement of the left coronary sinus (LCS) and multiple sinuses, rupture into the left ventricle (LV), and dissecting aneurysm of the interventricular septum (IVS) have all been scarcely reported.Case summaryA 24-year-old male presented with complaints of exertional fatigue, palpitations, and chest pain with signs of aortic run-off like wide pulse pressure, collapsing pulse along with cardiomegaly, and a diastolic murmur. Echocardiography revealed sinus of Valsalva aneurysms (SOVAs) involving both the RCS and LCS with RCS aneurysm dissecting the IVS and rupturing into the LV and another multilobulated aneurysm from LCS rupturing into the LV. Findings were confirmed on computed tomography (CT) aortogram, and the patient underwent successful surgical repair.DiscussionSinus of Valsalva aneurysm is a rare disorder which usually ruptures into the right-sided chambers. The involvement of multiple sinuses and rupture into the IVS is extremely rare (<2%). Aneurysm dissecting the IVS can lead to complete heart block (CHB) and sudden death. Involvement of the LCS is reported in <5% cases of RSOV, and rupture of such an aneurysm into the pericardial space may lead to cardiac tamponade and can also lead to sudden death. Clinical examination, electrocardiogram, chest X-ray, 2D echocardiography, and CT all help in the diagnosis. Treatment involves surgical repair of the defect.
| S-EPMC11350371 | biostudies-literature
Project description:ObjectiveTo evaluate the value and improve the diagnostic accuracy of echocardiography in the diagnosis of a sinus of Valsalva aneurysm (SVA) with rare pathological patterns.MethodsEchocardiographic features and surgical findings from 270 Chinese patients with SVA treated in the last 18 years (1995-2013) at the Union Hospital were compared retrospectively; 22 of 270 cases had rare patterns.ResultsThe patients with SVA, a rare origin, a rare extending position, or a rare course accounted for 3.4%, 7.4%, and 0.4% of the 270 cases, respectively. The three most common aneurysmal complications of the patients with rare patterns were severe aortic regurgitation (16), obstruction of the ventricular outflow tract or valvular orifice (3), and conduction disturbance (3). The origin, course, extending position and rupture status of the SVAs determined by echocardiography were entirely consistent with surgical findings in 81.8% of the 22 cases. With the exception of one failed diagnosis of an aneurysmal wall dissection and one misdiagnosis of a descending aortic dissection, the echocardiographic results of SVA complications and associated cardiovascular lesions were also confirmed.ConclusionWe could accurately diagnose SVAs with rare pathological patterns by echocardiographic identification of distinguishing features. However, for several conditions, we could not accurately identify the origin or course of the aneurysm or define its relationship to adjacent structures using conventional echocardiography alone. Therefore, we recommend combining conventional echocardiography with different imaging techniques, such as transesophageal echocardiography, three-dimensional echocardiography, computed tomography angiography, and aortic angiography.
| S-EPMC5349664 | biostudies-literature
Project description:A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA) that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85%) but it has been seen rarely in non-coronary (10%-30%) or Left coronary sinus (<5%). The most common complication is rupture of the Aneurysm. We present an 80-year-old male with expanding right Valsalva sinus aneurysm and protruding into right ventricle. The conventional treatment is surgical repair under cardio-pulmonary bypass or percutaneous catheter closure. The aneurysm was successfully excised surgically under direct guidance of trans-esophageal echocardiography (TEE).
| S-EPMC4586600 | biostudies-literature
Project description:BackgroundAn aortic sinus of Valsalva aneurysm (SVA) often remains undiagnosed until it ruptures. An SVA filled with thrombus can be challenging to diagnose accurately.Case summaryA 70-year-old man was admitted with a clinical diagnosis of well-tolerated complete atrioventricular block (AVB). Transthoracic echocardiography revealed a spherical mass (43 × 49 mm) at the interatrial septum. Enhanced computed tomography (CT) showed a well-defined, hollow, and non-enhanced mass suggesting a cardiac tumour. However, 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) showed no uptake in the mass. After implantation of a permanent pacemaker, anticoagulant therapy was started for paroxysmal atrial fibrillation. Two months later, follow-up evaluation by echocardiography and enhanced CT revealed an increase in size of the hollow interior cavity, suggesting thrombolysis by the anticoagulant. We diagnosed a non-coronary SVA filled with thrombus, which masqueraded as a cardiac tumour and may have caused complete AVB.ConclusionsWe describe a rare case of a giant thrombosed SVA masquerading as a cardiac tumour. Initial 18F-FDG PET/CT and serial imaging studies were helpful in distinguishing it from a cardiac tumour.
| S-EPMC8374963 | biostudies-literature
Project description:Background?:A sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly. Most SVA's rupture into right heart chambers and can be classified using the modified Sakakibara classification according to the site of rupture. Transoesophageal echocardiography (TOE) is a useful diagnostic tool and aides in treatment planning in patients with congenital anomalies in emergency situations. Three-dimensional TOE (3D-TOE) provides additional value over standard TOE. Case summary:A 38-year-old man with a reported history of ventricular septal defect (VSD) presented to the emergency department complaining of chest pain and epigastric pain lasting several days. Physical examination revealed a continuous heart murmur and signs of acute heart failure. A 3D-TOE revealed an SVA rupture into the right ventricle (Type IIIv) but no evidence of a VSD. Urgent aortic valve replacement with correction of the ruptured SVA was performed. Neither a VSD nor signs of endocarditis were found during surgical exploration. The patient was discharged on post-operative Day 5 in good condition. Discussion:A sinus of Valsalva aneurysm is a rare cardiac condition. Ventricular septal defect, bicuspid aortic valve, or aortic valve regurgitation may coexist with SVA. Xin-Jin et al. classified a ruptured SVA into five types according to the site of rupture. Transoesophageal echocardiography is an important tool for diagnosis, anatomical description, and typing of the ruptured SVA. Sinus of Valsalva aneurysm may be misdiagnosed as a VSD, as was the case in our patient, and 3D-TOE can be instrumental for providing both correct diagnosis and critical surgical planning.
| S-EPMC6764532 | biostudies-literature
Project description: Not available
| S-EPMC8712994 | biostudies-literature
Project description:A 54-year-old male with a history of unrepaired ventricular septal defect (VSD) suffered from easy fatigability on exertion. A Levine grade V/VI continuous murmur was auscultated. Transthoracic echocardiogram showed a ruptured sinus of Valsalva aneurysm (SVA) and a significant left-to-right shunting from the ascending aorta to the right ventricle (RV). In addition, a 36 mmHg of pressure gradient was observed between the inflow and outflow tract in the RV, suggesting double-chambered RV (DCRV). Cardiac catheterization also revealed 33 mmHg of the pressure gradient in the mid-potion of the RV, which was coincident with DCRV. A calculated pulmonary-to-systemic flow ratio was 3.0. Therefore, the patient was offered surgical repair of the ruptured SVA and VSD, which was successfully performed. During the surgery, an anomalous muscle band, which is usually the cause of DCRV, was not found, instead, a thickened RV free-wall due to the exposure of the left-to-right shunt flow, so-named jet lesion, was found. Therefore, surgical resection of the anomalous muscle band was not required. The protruded SVA toward the RV, the jet lesion, and the increased RV stroke volume, which could induce relative stenosis, were the causes of the unusual DCRV. <Learning objective: A mechanism of an unusual double-chambered right ventricle induced by ruptured sinus of Valsalva aneurysm (SVA) is as follows. One is a morphological stenosis in the right ventricle (RV) due to a protruded SVA toward the RV. The second is a jet lesion; a thickened RV wall induced by the exposure of the shunt flow from the ascending aorta. The third is a relative stenosis due to the increased stroke volume of the RV.>.
| S-EPMC7588484 | biostudies-literature
Project description: Not available
| S-EPMC11367942 | biostudies-literature
Project description:Ruptured sinus of Valsalva aneurysm (RSOV) is an uncommon cause of high output heart failure. RSOV most commonly opens into the right ventricle followed by the right atrium and non-coronary cusp involvement is relatively uncommon. Infective endocarditis (IE) is a rare cause of RSOV. We report an interesting clinical scenario of IE causing RSOV managed by device closure. A 16-year-old male patient presented to the emergency department with acute chest pain, fever, and engorged neck veins. On cardiorespiratory system examination he had features of left ventricular failure. Blood culture revealed growth of Staphylococcus aureus. Echocardiography and computed tomography aortography confirmed the diagnosis of 9 mm type IV RSOV (non-coronary cusp to right atrium) with vegetation (5 × 6 mm). The patient refused surgery. When there was no apparent visible vegetation after 6 weeks of antibiotic therapy, we proceeded with 12-mm Amplatzer duct occluder II closure of the anatomical defect. Monthly follow up has been uneventful for 6 months. As per our knowledge this is the first ever reported case of documented definitive IE by S. aureus causing Sakakibara and Konno ruptured Type IV RSOV that has been managed successfully by device closure. <Learning objective: Ruptured sinus of Valsalva aneurysm (RSOV) secondary to native valve infective endocarditis (IE) can occur in apparently healthy young individuals with no predisposing factor. Device closure is a good therapeutic option in selective cases of RSOV secondary to native valve IE. Further research is needed to understand the role of device closure in such clinical settings as an alternative to surgical options.>.
| S-EPMC9091531 | biostudies-literature