Abstract
Rupture of sinus of Valsalva aneurysm (SVA) is a fatal complication, and early detection and immediate surgical correction is critical for lifesaving. However, achieving its definite diagnosis is challenging. Computed tomography (CT) can provide excellent diagnostic value for SVA rupture and other combined anomalies with better spatial resolution of cardiac structure. Herein, we described a case of a young woman with ruptured SVA. SVA rupture was suggested by transthoracic echocardiography and confirmed by cardiac CT. CT scan confirmed SVA rupture by revealing a ring-like structure originating from the right coronary sinus of the aortic valve protruding to the right ventricle with extravasation of the radiocontrast agent. This finding was not clearly defined by transthoracic echocardiography. Cardiac CT may be useful for the diagnosis of ruptured SVA by providing more detailed visualization of adjacent structures and additional information on combined cardiac pathology.
Highlights
Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly, and it is typically of congenital origin [1]
It has been reported that computed tomography (CT) can provide excellent diagnostic value for SVA rupture and combined anomalies with better spatial resolution of cardiac structure [4,5,6]
It has been demonstrated that supracristal ventricular septal defect (VSD) just below the right aortic cusp is associated with significant aortic regurgitation in approximately half cases, and can mimic ruptured SVA [8]
Summary
Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly, and it is typically of congenital origin [1]. Substernal chest pain was intermittent and of squeezing nature and it was not related to exercise She had been heard about a hole between cardiac chambers when she was young; she did not remember the correct diagnosis. TEE revealed a protruding aneurysmal sac with shunting from the right coronary sinus to RV (Figure 4 and Video 3). TTE no longer showed abnormal shunt flow at the aortic root except minimal valvular regurgitation of the AV (Figure 5 and Video 4). She has been doing well without chest symptoms after surgery
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