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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

The aneurysm sac of the sinus of valsalva.
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fig2: The aneurysm sac of the sinus of valsalva.

Mentions: After his complete evaluation, surgery was recommended. After initiating the cardiopulmonary bypass machine and arresting the heart function, a significant aortic valve insufficiency with perforation of the right and left aortic cusps in the base segment was observed. In addition, prolapse of the noncoronary aortic cusp into the large subarterial VSD was seen. The right coronary sinus of valsalva showed an aneurysmal formation that was attached to the right ventricle with a short tract. Also, there was a mild dilation of the aortic root and the ascending aorta. The aortic leaflet was also thin and perforated, and its excision was sent for a further pathological examination (Figure 2). After removing the aneurysmal sac of the right coronary artery, the defect that was created in the right ventricle (RV) was closed with a small piece of patch. Furthermore, the VSD was repaired using a Gore-Tex patch and the aortic valve replacement was performed with a St. Jude mechanical aortic prosthetic valve. Weaning the patient from cardiopulmonary bypass was successful, and the patient was discharged 1 week later after the recovery. In the follow-up period, echocardiography tests showed that the patient had no residual VSD, and a good hemodynamic status of the prosthetic valve was also observed.


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)

The aneurysm sac of the sinus of valsalva.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: The aneurysm sac of the sinus of valsalva.
Mentions: After his complete evaluation, surgery was recommended. After initiating the cardiopulmonary bypass machine and arresting the heart function, a significant aortic valve insufficiency with perforation of the right and left aortic cusps in the base segment was observed. In addition, prolapse of the noncoronary aortic cusp into the large subarterial VSD was seen. The right coronary sinus of valsalva showed an aneurysmal formation that was attached to the right ventricle with a short tract. Also, there was a mild dilation of the aortic root and the ascending aorta. The aortic leaflet was also thin and perforated, and its excision was sent for a further pathological examination (Figure 2). After removing the aneurysmal sac of the right coronary artery, the defect that was created in the right ventricle (RV) was closed with a small piece of patch. Furthermore, the VSD was repaired using a Gore-Tex patch and the aortic valve replacement was performed with a St. Jude mechanical aortic prosthetic valve. Weaning the patient from cardiopulmonary bypass was successful, and the patient was discharged 1 week later after the recovery. In the follow-up period, echocardiography tests showed that the patient had no residual VSD, and a good hemodynamic status of the prosthetic valve was also observed.

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