Edit concept Question Editor Create issue ticket

Ruptured Sinus of Valsalva Aneurysm


Presentation

  • 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]
  • Echocardiography showed that RSVA presented in the right coronary cusp. The sinus opened into the right atrium, and the diameter of the opening was 5 mm.[ncbi.nlm.nih.gov]
  • Very rarely, they present with acute symptoms as a result of rupture into the cardiac chamber. If left untreated, they almost always result in deteriorating cardiac function.[ncbi.nlm.nih.gov]
  • Abstract Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly either presenting as a congenital heart disease or occurring secondary to cardiac surgical interventions.[ncbi.nlm.nih.gov]
  • The results of transcatheter closure of the RSVA in 10 patients were presented. METHODS: From January 2000 to May 2006, 10 patients (4 males, 6 females) aged from 7 years to 69 years (mean ages 37 /-18.8 years) were involved in the present report.[ncbi.nlm.nih.gov]
Congestive Heart Failure
  • Abstract We report the case of a 16-year-old boy with Marfan syndrome who presented in severe congestive heart failure secondary to rupture of an aneurysm of the sinus of Valsalva into the right atrium, a condition that was aggravated by coarctation of[ncbi.nlm.nih.gov]
  • Ruptured sinus of Valsalva aneurysm is an unusual cause for congestive heart failure, and anomalous coronary arteries have rarely been found in association.[ncbi.nlm.nih.gov]
  • Sinus of Valsalva aneurysm is a rare cardiac malformation that stems from incomplete fusion of the aortic media and the aortic valve annulus, a weakness that may result in rupture of the sinus, large left-to-right shunt, and severe congestive heart failure[ncbi.nlm.nih.gov]
  • One patient died of progressive congestive heart failure while other six are asymptomatic. These data highlight that transcatheter closure is feasible and effective, especially safe with the available Amplatzer devices.[ncbi.nlm.nih.gov]
Down Syndrome
  • This fourth case report of sinus of Valsalva aneurysm occurring in association with Down syndrome is the youngest to date. Physicians caring for Down syndrome patients ought to be aware of this late onset cardiac malformation.[ncbi.nlm.nih.gov]
  • We report a case of a 33-year-old man with Down syndrome and ruptured sinus of Valsalva aneurysm (SOVA) plus large ostium secundum atrial septal defect (ASD) with attenuated inferior rim.[ncbi.nlm.nih.gov]
Orthopnea
  • The observed symptoms were as follows: dyspnoea, orthopnea, chest pain, palpitations, and syncope. In 4 patients there was congenital RSVA. One of them (Table, patient 2) underwent surgical closure of RSVA one year before this procedure.[revespcardiol.org]
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]
  • A harsh, continuous murmur was noted on physical examination. Transthoracic and transesophageal echocardiograms were interpreted as showing a ruptured sinus of Valsalva aneurysm with a shunt into the right atrium and a tricuspid valve vegetation.[ncbi.nlm.nih.gov]
  • On physical examination, a grade 3/6 continuous murmur was heard in the left lower sternal border.[link.springer.com]
  • Small defects may not cause symptoms, but can be diagnosed by the presence of a prominent continuous murmur. Larger defects may cause symptoms of shortness of breath and volume overload of the heart.[columbiacardiology.org]
Heart Disease
  • Abstract Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly either presenting as a congenital heart disease or occurring secondary to cardiac surgical interventions.[ncbi.nlm.nih.gov]
  • We briefly review the association between congenital heart disease, situs ambiguus, and ciliary dysfunction.[ncbi.nlm.nih.gov]
  • None of the patients had other associated congenital heart disease, and all underwent local anesthesia. Transthoracic echocardiography was used during the procedure.[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]
  • Discussion An SVA is a rare congenital heart disease with incidences of 0.5% to 3% among all congenital heart diseases. SVA could occur in the right and left sinuses and in a noncoronary aortic sinus.[ncbi.nlm.nih.gov]
Diastolic Murmur
  • 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]
  • 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 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]
  • The heart rate was regular, and systolic and diastolic murmurs were heard over the right sternal border.[jtd.amegroups.com]
  • Shunt from the aortic root to the left ventricle may produce a diastolic murmur similar to that of aortic insufficiency. Pulmonary rales may be present from progressive left heart failure.[chdbabies.com]
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]
  • 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]
Withdrawn

Workup

  • 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]

Treatment

  • The conventional treatment of RSVA is surgical repair under cardio-pulmonary bypass (CPB) or percutaneous catheter closure.[ncbi.nlm.nih.gov]
  • BACKGROUND: Ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly and long-term survival after surgical treatment is not well established.[ncbi.nlm.nih.gov]
  • Surgical repair has been the traditional treatment of for the RSVA. The results of transcatheter closure of the RSVA in 4 patients are reported.[ncbi.nlm.nih.gov]
  • 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]
  • We report successful simultaneous transcatheter treatment of both these defects performed in the same setting in an acutely ill adult male patient with a good intermediate-term follow-up.[ncbi.nlm.nih.gov]

Prognosis

  • 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]
  • Prognosis in patients with a ruptured aneurysm who have not undergone surgical repair may be poor, with survival beyond 1 year uncommon.[chdbabies.com]
  • Treatment and prognosis Surgical repair with a Bentall procedure could be performed.[radiopaedia.org]
  • The postoperative prognosis appears to be better if the surgeon can avoid aortic valve replacement due to the subsequent prosthetic dysfunction [ 16 ].[ncbi.nlm.nih.gov]
  • 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]

Etiology

  • 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]
  • 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]
  • Although the etiology of SVA is congenital, generally, a minority of this anomaly could be attributed due to trauma, infection, degeneration, and collagen vascular disease [ 7 , 8 ].[ncbi.nlm.nih.gov]
  • Conclusion Percutaneous closure of ruptured sinus of Valsalva is easier when it's etiology, location, size, distant from coronary artery ostium, distance from aortic valve, neighboring structures, associated congenital defects, and complications are properly[nigjcardiol.org]

Epidemiology

  • 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]
  • Global Tuberculosis Control: epidemiology, strategy, financing. World Health Organization. WHO/HTM/TB/2009.411.WHO Report;(2006), , Surveillance of Tuberculosis in Europe-Euro TB.[citeulike.org]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • 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]
  • ., The role of the lachrymal functional unit in the pathophysiology of dry eye (2004) Exp Eye Res, 78, pp. 409-416; Zoukhri, D., Effect of inflammation on lachrymal gland function (2006) Exp Eye Res, 82, pp. 885-898; In Cornea, Vol. 30 (2011), 1-6 Abstract[citeulike.org]

Prevention

  • An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease.[ncbi.nlm.nih.gov]
  • 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]
  • Early surgical repair is indicated to prevent complications such as heart failure, infective endocarditis, arrhythmias, and thromboembolic events.[ncbi.nlm.nih.gov]
  • Device was manipulated and deployed with an angle so as to prevent aortic valve dysfunction. 2010 Wiley-Liss, Inc.[ncbi.nlm.nih.gov]
  • Prompt recognition and surgical repair are indicated to prevent complications of myocardial infarction.[ncbi.nlm.nih.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!