Aneurysmal dilation less commonly affects the left sinus and rupture into the right atrium is still rarer and a chronic insidious presentation as in this case is odd. [ncbi.nlm.nih.gov]

• Surgical Procedure

  A good prognosis depends on early diagnosis and prompt surgical intervention. However, we think the best surgical procedure is modified Button Bental procedure, as we did in our case. [omicsonline.org]

  SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery. 1. [ncbi.nlm.nih.gov]

  Preoperative variables and surgical procedures are summarized in Tables 1 and 2, respectively. The study was approved by the Institutional Human Ethics Committee, and all patients gave consent for the procedure. [cardiothoracicsurgery.biomedcentral.com]

• 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]

• 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]

• Regurgitation

  OBJECTIVES: Recurrent or newly developing aortic regurgitation is a critical problem after the repair of ruptured sinus of Valsalva aneurysm. [ncbi.nlm.nih.gov]

  Mild-to-moderate aortic valve regurgitation was observed in one patient. There was no recurrence of left-to-right shunt from the ruptured aneurysms of the sinus of Valsalva or aortic regurgitation due to sinus of Valsalva distortion. [cardiothoracicsurgery.biomedcentral.com]

• Heart Failure

  Sudden aneurysm rupture can trigger rapidly progressive heart failure. We discuss the case of a 57-year-old woman with situs ambiguus, isolated levocardia, and polysplenia who presented with acute-onset heart failure. [ncbi.nlm.nih.gov]

  Presentation varies from asymptomatic findings to acute heart failure, which can rapidly worsen to cause death. [casereports.bmj.com]

• Continuous Murmur

  Patients with a coronary aneurysm alone do not generally exhibit continuous murmurs; however, murmurs may be detected in the presence of a fistula. [ncbi.nlm.nih.gov]

  The diagnostic work-up for a pre-cordial continuous murmur mostly consists of echocardiography. [ecrjournal.com]

  On physical examination, a grade 3/6 continuous murmur was heard in the left lower sternal border. [link.springer.com]

• Heart Disease

  We briefly review the association between congenital heart disease, situs ambiguus, and ciliary dysfunction. [ncbi.nlm.nih.gov]

  University of Medicine, Silesian Center for Heart Diseases, Zabrze, Poland b Computed Tomography Department, Silesian University of Medicine, Silesian Center for Heart Diseases, Zabrze, Poland Keywords Catheterization. [revespcardiol.org]

  Larger defects may cause symptoms of shortness of breath and volume overload of the heart. Surgical repair is indicated but requires expertise in the repair of congenital heart disease. [columbiacardiology.org]

• Diastolic Murmur

  His physical examination revealed a thrill localized in the 5th intercostal space on the right edge of the sternum and systolic-diastolic murmur beginning from the aortic focus and spreading to the neck and back along the right edge of the sternum. [unboundmedicine.com]

  On auscultation, a grade 4/6 early diastolic murmur was heard over the left lower sternal border and Erb's area with a thrill. Crepitating rales were heard over bilateral basal lung fields. [ncbi.nlm.nih.gov]

  The heart rate was regular, and systolic and diastolic murmurs were heard over the right sternal border. [jtd.amegroups.com]

  Physical signs may include the following: A loud continuous murmur, accentuated in the diastole, occurs with aneurysm rupture into the right ventricle or right atrium. [chdbabies.com]

  On auscultation S1 was normal and S2 was soft with grade III/VI diastolic murmur in aortic area. Patient was properly investigated. ECG showed sinus rhythm and X-ray chest was showing cardiomegaly. [medcraveonline.com]

• Heart Murmur

  We report the case of a 35-year-old pregnant woman who presented at the hospital for cardiac evaluation due to the presence of a heart murmur. The patient was asymptomatic and in her 4th month of pregnancy. [ncbi.nlm.nih.gov]

  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]

• Suggestibility

  The early experience with real-time two-dimensional Doppler flow imaging suggests that this noninvasive technique is valuable in the management of ruptured sinus of Valsalva aneurysms. [ncbi.nlm.nih.gov]

  Despite a slightly longer bypass time, we suggest adopting this technique to deal with congenital cases of ruptured or re-ruptured sinus valsalva aneurysm. [thieme-connect.com]

• Withdrawn

  The device was withdrawn and the procedure abandoned. [revespcardiol.org]

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]

• Streptococcus Pneumoniae

  We report an unusual case of ruptured sinus of Valsalva aneurysm associated with endocarditis that was caused by Streptococcus pneumoniae serotype 21. [ncbi.nlm.nih.gov]

  Endocarditis with ruptured sinus of Valsalva aneurysm caused by nonvaccine Streptococcus pneumoniae serotype 21. Tex Heart Inst J 2012;39:277-80. [ PubMed ] Vereckei A, Vándor L, Halász J, et al. [jtd.amegroups.com]

The conventional treatment of RSVA is surgical repair under cardio-pulmonary bypass (CPB) or percutaneous catheter closure. [ncbi.nlm.nih.gov]

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]

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

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]

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

A good prognosis depends on early diagnosis and prompt surgical intervention. However, we think the best surgical procedure is modified Button Bental procedure, as we did in our case. [omicsonline.org]

Discussion was made on the etiology and differential diagnosis. [ncbi.nlm.nih.gov]

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]

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]

This case is unusual because of the patient's young age at presentation, the absence of predisposing factors, and the isolation of a nonvaccine serotype 21, which revealed the epidemiologic changes of invasive pneumococcal disease. [ncbi.nlm.nih.gov]

In Ophthalmic Epidemiology, Vol. 16 (2009), 15-21 Abstract Purpose: To estimate the prevalence of dry eye and to investigate its relationship with lifestyle and systemic factors in a general adult population in north-western Spain. [citeulike.org]

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]

The association of aneurysm with hypertension and smoking, as well as local atheromatous degenerative changes, coronary and cerebral atherosclerotic etiology simultaneously support, but the controversy is served after the publication of several epidemiological [clinicazurbano.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 Aneurysmal dilatation of the sinuses of Valsalva occurs when the aortic media is defective, allowing separation of the media from the aortic annulus fibrosus. [chdbabies.com]

[…] 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]

The two cases that are presented in this article have different pathophysiology. In the first case, the etiology is atherosclerosis causing coronary artery disease, degeneration and aneurysm formation of the right coronary sinus. [heartviews.org]

An early, aggressive treatment should be recommended to prevent postoperative AR, and a direct-suture closure of RSVA should be avoided to prevent early worsening of AR. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. [ncbi.nlm.nih.gov]