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Unruptured Aneurysm of Sinus of Valsalva Coexisting with the Large Ventricular Septal Defect and Severe Aortic Regurgitation in a Young Man.

Nezafati P, Nezafati MH, Hoseinikhah H - Case Rep Med (2015)

Bottom Line: Discussion.Conclusion.SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery.

View Article: PubMed Central - PubMed

Affiliation: Cardiac Surgery Research Committee, Mashhad University of Medical Sciences, Mashhad 9137913316, Iran.

ABSTRACT
Introduction. Unruptured sinus of valsalva aneurysm (SVA) is a rare congenital anomaly, particularly, when it coexists with a ventricular septal defect (VSD) and aortic regurgitation due to the prolapse of the elongated aortic cusp into the VSD. In this report, we present the case of a 19-year-old young man with VSD challenging in spite of dyspnea and lower limb edema. Presentation of Case. Its diagnosis was made on the basis of transthoracic echocardiography results. Surgical management consisted of replacing the SVA with mechanical valve prosthesis. A Gore-Tex patch repaired the VSD. Discussion. In the follow-up periods, clinical and echocardiographic tests showed that the patient was in excellent status. Conclusion. SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery.

No MeSH data available.


Related in: MedlinePlus

Chest X-ray showing the massive cardiomegaly.
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fig1: Chest X-ray showing the massive cardiomegaly.

Mentions: A 19-year-old young man had a two-year history of exertional dyspnea, lower limb edema, periodic chest pain, and jaundice. The patient was in NYHA classes II and III with his symptoms progressively worsening over time. His past medical history indicated the successful balloon angioplasty and stenting for coarctation of the aorta (COA) at the age of 15, which left an arterial hypertension and no significant residual COA, and in the follow-up periods. His clinical evaluation based on the chest X-ray findings showed cardiomegaly, particularly, in the right ventricle and pulmonary congestion (Figure 1). Laboratory data showed that he had a mild increase in the serum creatinine (Cr), bilirubin (BIL), and nonalcoholic fatty liver disease (NAFLD). Furthermore, transthoracic echocardiographic examination (TTE) indicated that the patient had a large VSD and prolapse of the noncoronary cusp of the aorta into the VSD due to severe aortic regurgitation. Left ventricular (LV) ejection fraction (EF) index was about 40%, left ventricle end diastolic diameter (LVEDD) was 75 mm, and left ventricle end systolic diameter (LVESD) was 55 mm. The catheterization prior to surgery indicated that Qp/Qs was 2.2. Also his pulmonary artery pressure was estimated to be 60 mm Hg and the pulmonary artery pressure to aortic pressure ratio was 0.7.


Unruptured Aneurysm of Sinus of Valsalva Coexisting with the Large Ventricular Septal Defect and Severe Aortic Regurgitation in a Young Man.

Nezafati P, Nezafati MH, Hoseinikhah H - Case Rep Med (2015)

Chest X-ray showing the massive cardiomegaly.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4508464&req=5

fig1: Chest X-ray showing the massive cardiomegaly.
Mentions: A 19-year-old young man had a two-year history of exertional dyspnea, lower limb edema, periodic chest pain, and jaundice. The patient was in NYHA classes II and III with his symptoms progressively worsening over time. His past medical history indicated the successful balloon angioplasty and stenting for coarctation of the aorta (COA) at the age of 15, which left an arterial hypertension and no significant residual COA, and in the follow-up periods. His clinical evaluation based on the chest X-ray findings showed cardiomegaly, particularly, in the right ventricle and pulmonary congestion (Figure 1). Laboratory data showed that he had a mild increase in the serum creatinine (Cr), bilirubin (BIL), and nonalcoholic fatty liver disease (NAFLD). Furthermore, transthoracic echocardiographic examination (TTE) indicated that the patient had a large VSD and prolapse of the noncoronary cusp of the aorta into the VSD due to severe aortic regurgitation. Left ventricular (LV) ejection fraction (EF) index was about 40%, left ventricle end diastolic diameter (LVEDD) was 75 mm, and left ventricle end systolic diameter (LVESD) was 55 mm. The catheterization prior to surgery indicated that Qp/Qs was 2.2. Also his pulmonary artery pressure was estimated to be 60 mm Hg and the pulmonary artery pressure to aortic pressure ratio was 0.7.

Bottom Line: Discussion.Conclusion.SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery.

View Article: PubMed Central - PubMed

Affiliation: Cardiac Surgery Research Committee, Mashhad University of Medical Sciences, Mashhad 9137913316, Iran.

ABSTRACT
Introduction. Unruptured sinus of valsalva aneurysm (SVA) is a rare congenital anomaly, particularly, when it coexists with a ventricular septal defect (VSD) and aortic regurgitation due to the prolapse of the elongated aortic cusp into the VSD. In this report, we present the case of a 19-year-old young man with VSD challenging in spite of dyspnea and lower limb edema. Presentation of Case. Its diagnosis was made on the basis of transthoracic echocardiography results. Surgical management consisted of replacing the SVA with mechanical valve prosthesis. A Gore-Tex patch repaired the VSD. Discussion. In the follow-up periods, clinical and echocardiographic tests showed that the patient was in excellent status. Conclusion. SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery.

No MeSH data available.


Related in: MedlinePlus