Copyright © 2005, The European Society of Cardiology
Rupture of a left sinus of Valsalva aneurysm into the pulmonary artery
aDepartment of Cardiology, University of Palermo, Palermo, Italy
bDepartment of Cardiology, University of Maputo, Mozmabique
Received 9 September 2005; received in revised form 8 November 2005; accepted after revision 17 November 2005.
* Corresponding author. Department of Cardiology, University of Palermo, Palermo, Italy. Tel.: +39 091 442538. giovanni.fazio-aaaa{at}poste.it
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Abstract |
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Sinus of Valsalva aneurysm is a rare congenital defect and the diagnosis is usually made after it ruptures. Very few cases of non-complicated sinus of Valsalva aneurysm have been published. The anomaly most often involves the right coronary sinus and less frequently the non-coronary sinus. A case with left sinus of Valsalva has not been reported. Since the aortic valve occupies a central position in the base of the heart, rupture of a sinus of Valsalva aneurysm can occur in any of the four heart chambers. Rupture into the pulmonary artery is very rare and is mostly associated with other congenital cardiopathies.
Keywords: Sinus of Valsalva; Aneurysm; Rupture into the pulmonary artery
A 30-year-old patient is presented. Five years ago, during a routine control, the diagnosis of HIV was made. Since he did not take any treatment the disease had evolved causing a Kaposi sarcoma, which was diagnosed about 6 months before admission. He presented dyspnea, ascites and peripheral oedema. Physical examination revealed a systolo-diastolic murmur located high at the left sternal border (grade IV/VI). Blood pressure was 150/60mmHg. Chest X-ray showed an enlarged cardiac shadow and pulmonary congestion. The ECG (Fig. 1) revealed right ventricular hypertrophy. Echocardiography showed normal left ventricular cavity dimensions with normal wall thickness and function. The right heart cavities were dilated with wall hypertrophy (Fig. 2, panels E and F). At the aortic root level there was an aorta–pulmonary communication indicating a rupture of the left sinus of Valsalva (Fig. 2, panels A and B). The pulmonary artery was dilated. The color Doppler images showed the blood shunting from the aorta to the pulmonary artery (Fig. 2, panels C and D).1,2 After this diagnosis we started a medical therapy. Surgical closure of the defect was performed one week later.3
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We are grateful to Dr. Nicoletta Vinci for translating the article to English.
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- Shiraishi S., Watarida S., Katsuyama K., Nakajima Y., Imura M., Nishi T. Unruptured aneurysm of the sinus of Valsalva into the pulmonary artery. Ann Thorac Surg (1998) 65:1458–1459.
[Abstract/Free Full Text] - Kar A.K., Bhattacharya S., Ray D., Mondal M., Ghosh S., Mazumdar A. Rupture of the sinus of Valsalva into the pulmonary artery. Indian Heart J (2002) 54:415–417.[Medline]
- Hamid I.A., Jothi M., Rajan S., Monro J.L., Cherian K.M. Transaortic repair of ruptured aneurysm of sinus of Valsalva. Fifteen-year experience. J Thorac Cardiovasc Surg (1994) 107:1464–1468.
[Abstract/Free Full Text]
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