Abstract
Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA) with severe dilatation of the right coronary sinus in association with a congenital bicuspid aortic valve (BAV) and sub-aortic membrane. The SVA had not been apparent on echocardiography as the dilatation was outside standard echo image planes. On both CMR and echo, blood flow was eccentrically directed into the right coronary sinus by the domed posterior leaflet of the BAV. The impact of the aortic jet on the wall of the right coronary sinus is probably important in the aetiology of the sinus dilatation. CMR proved valuable in demonstrating the SVA and understanding its aetiology.
Highlights
Abstract sinus with a maximum dimension across the aortic sinus of 5.7 cm
The Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA), which had not been apparent on the echo images because it was outside standard imaging planes (Figure 1A, 1B; Supplementary files 1 and 2)
Figure 2. 2-dimensional (A) and colour Doppler (B)echocardiography in an apical 5-chamber view demonstrating an eccentric jet of flow directed through the aortic valve towards the right coronary sinus
Summary
Abstract sinus with a maximum dimension across the aortic sinus of 5.7 cm. On CMR flow was directed eccentrically by the domed posterior leaflet of the BAV into the right coronary sinus (Figure 1D; Supplementary file 3). He underwent successful repair of the SVA and resection of the sub-aortic membrane and remained well when followed up in clinic. Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA) with severe dilatation of the right coronary sinus in association with a congenital bicuspid aortic valve (BAV) and subaortic membrane.
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