We present a case report of a ruptured sinus of Valsalva aneurysm (SVA) that presented as aortic insufficiency following bacterial endocarditits in a cardiac transplant patient. [ncbi.nlm.nih.gov]

Approximately 5–10% of patients present with acute endocarditis. 3 In the present case, there was no such precipitating cause for the sudden rupture. Conventionally, surgical repair of the RSVA has been the mainstay of therapy. [invasivecardiology.com]

• Recurrent Infection

  There was no AR progression, recurrence, infective endocarditis, or device embolization. CONCLUSION: In appropriately selected patients with ruptured SOVA, TCC is an attractive alternative to surgery with encouraging short- and mid-term outcomes. [ncbi.nlm.nih.gov]

• Turkish

  Case Report 50-year-old Turkish man was admitted with a history of weakness, and mild dyspnea with a 2-year diagnosis history as an aneurysm of the ascending aorta. There was no history of recent chest pain or injury. [omicsonline.org]

• Right Upper Quadrant Pain

  We report the case of a 28-years-old man which was referred to hospital due to right upper quadrant pain without irradiation and emphasizing a dynamic dyspnea and fatigue. [romanianjournalcardiology.ro]

• Heart Murmur

  We here report the case of a 26 years old pregnant woman who was referred to our cardiac center for the evaluation of a heart murmur. [ncbi.nlm.nih.gov]

  Full Text A 36-year-old man was referred to our hospital for a recent finding of a heart murmur. He had no relevant medical history except paroxysmal palpitations in the previous three months. [elsevier.pt]

  Conclusion A rupture of a sinus of Valsalva has to be taken into account in the differential diagnosis of a continuous heart murmur, even though the patient looks healthy and is asymptomatic. [ecrjournal.com]

  DISCUSSIONS In young patients (mostly male – 4:1 ratio – and middleaged), the ruptured aneurysms of sinus of Valsalva may initially be asymptomatic or may be manifested by acute heart failure with the emergence of new heart murmurs imposing a differential [romanianjournalcardiology.ro]

• To-and-Fro Murmur

  The patient had a to-and-fro murmur, grade 5/6 systolic and 3/6 diastolic, which was most strongly audible over the left sternal border. A right ictus was palpable with lateral displacement of the left ictus. [ecrjournal.com]

  murmur (see Figure 23-17 ). [clinicalgate.com]

• Normal Stature

  Concerning the etiologic diagnosis, it was ruled out syphilis (VDRL negative) and Marfan syndrome (no eyes disorder, normal stature, normal fingers)3,4. [romanianjournalcardiology.ro]

• Dermatitis

  She had no history of medical problems, except for atopic dermatitis (AD). Blood cultures identified methicillin-sensitive Staphylococcus aureus. [ncbi.nlm.nih.gov]

Surgery has good reputation having a [2] Transcatheter closure (TCC) of ruptured sinus of Valsalva aneurysm (RSOVA) appears to be a reasonable alternative. [3], [4] A thorough workup of location, size, proximity to neighboring structures, complications [nigjcardiol.org]

• T Wave Abnormality

  Electrocardiogram can objectify left/right ventricle hypertrophy and non-specifi c ST segment/ T wave abnormalities. The management of RSVA is guided by clinical and echocardiographical fi ndings. [romanianjournalcardiology.ro]

Although the classical treatment method of ruptured SVA is surgical repair, percutaneous closure devices may be used as a reliable alternative method in suitable patients. [unboundmedicine.com]

OBJECTIVES: Different surgical strategies have been evolved for the surgical treatment of ruptured sinus of Valsalva aneurysm (RSVA) from simple primary closure to patching of the rupture site by a dual chamber approach. [ncbi.nlm.nih.gov]

Percutaneous treatment of a ruptured sinus Valsalva aneurysm with double orifices [Turk Kardiyol Dern Ars] Turk Kardiyol Dern Ars. 2013; 41(1): 59-63 | DOI: 10.5543/tkda.2013.58812 Percutaneous treatment of a ruptured sinus Valsalva aneurysm with double [archivestsc.com]

Prognosis in patients with a ruptured aneurysm who have not undergone surgical repair may be poor, with survival beyond 1 year uncommon. [chdbabies.com]

Urgent surgical repair for ruptures aneurysms Many recommend surgical repair of non-ruptures aneurysms as well Complications Rupture (see above) Myocardial infarction Heart block Right ventricular outflow tract obstruction Cardiac tamponade Sudden death Prognosis [learningradiology.com]

The prognosis of ruptured SOVA is poor and patients usually succumb to acute cardiac failure [ 2 ]. Early diagnosis and treatment are generally associated with a good outcome. [link.springer.com]

Treatment and prognosis Surgical repair with a Bentall procedure could be performed. [radiopaedia.org]

Early diagnosis and proper therapeutic treatment can significantly affect the patient's prognosis. [muni.cz]

An anatomic etiology of symptoms may be suspected with heart auscultation (murmur), and diagnosis is made by a routine echocardiogram or, if the patient is suspected of having coronary disease as the etiology of symptoms, an angiogram. [hqmeded-ecg.blogspot.com]

Infectious etiologies that weaken elastic tissue and are associated with acquired Sinus of Valsalva aneurysm include syphilis, bacterial endocarditis, and tuberculosis. [ncbi.nlm.nih.gov]

Root replacement or Ross procedure maybe used if severe local septic etiology. Complications Rupture into RV > RA > LV > IVS/PA leads to formation intracardiac fistulae or tamponade. [pie.med.utoronto.ca]

The etiology of the aneurysm seems atherosclerotic as suggested by age of the patient, atherosclerotic changes visualized on computed tomography imaging of the aorta and histopathology of the surgically excised aneurysm. [annalspc.com]

Asian countries than in the West. 2 Though acquired aneurysms of the aortic sinus have been described postoperatively 9 as also due to atherosclerosis, 10 the typical saccular shape and location of the aneurysm in our patient suggested a congenital etiology [invasivecardiology.com]

Epidemiology The estimated rate of Sinus of Valsalva aneurysm is approximately 0.09% of the general population, based on large autopsy series. SOVAs comprise up to 3.5% of all congenital heart defects. [ncbi.nlm.nih.gov]

Cardiac tamponade may occur if the rupture involves the pericardial space. [1] Epidemiology Frequency United States SVA was present in 0.09% of cadavers in a large autopsy series and ranged to 0.14-0.23% in a Western surgical series. [4] Two-dimensional [emedicine.medscape.com]

Pathophysiology Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology Sinus of Valsalva Aneurysm: Gross; a beautiful picture of windsock opening of aneurysm [wikidoc.org]

Associated conditions include: Syphilis Trauma Endocarditis Atherosclerosis Marfans (diffuse dilatation) Uncommon – Ehlers Danlos (other connective tissue disorders), Takayasu arteritis (other vasculitides), post AV replacement Pathophysiology Congenital [pie.med.utoronto.ca]

Pathophysiology Non-ruptured sinus of Valsalva aneurysm is usually asymptomatic. However, non-ruptured sinus of Valsalva aneurysm can lead to cardiac arrhythmias; atrial fibrillation and complete heart block have both been described. [ncbi.nlm.nih.gov]

[…] intracardiac shunting caused by rupture of the SVA into the right side of the heart. [1] Approximately 65-85% of SVAs originate from the right sinus of Valsalva, while SVAs originating from noncoronary (10-30%) and left sinuses (< 5%) are exceedingly rare. [2] Pathophysiology [emedicine.medscape.com]

An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease. [ncbi.nlm.nih.gov]

Deterrence/Prevention Because the genetic mutation that causes the sinus of Valsalva aneurysm is presumed to be spontaneous, no preventive measures are available. [chdbabies.com]

A mean survival period of 3,9 years in patients with untreated ruptured sinus of Valsalva aneurysms has been reported. 1 An early, aggressive approach is recommended to prevent clinical deterioration. 1,2,4,6 Operative procedures include simple plication [ecrjournal.com]