Abstract
Backgroud: Valsalva sinus aneurysms are abnormalities of the heart that can be acquired or congenital. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency. Transcatheter closure has recently emerged as an alternative but surgery still has indications. Aim: We report our experience on the management of this pathology in a subsaharian country. Patient and method: We report the observation of a 7.5-year-old child whose discovery was fortuitous upon exploration of a heart murmur. Results: Doppler echocardiography made the diagnosis possible showing a large under pulmonary interventricular septal defect with a right left shunt, a small non-stenotic sub-aortic membrane, a bicuspid aortic valve without leakage or stenosis, a significant dilation of the aortic root. The surgical management was an intervention according to Tyrone-David technique with closure of the interventricular septal defect. Postoperative outcomes were simple and the short- to medium-term evolution favorable. Conclusion: Depending on the definition used to diagnose valsalva sinus aneurysms, the frequency of this pathology may be underestimated. What seems most appropriate to us is the definition considering the diameter of the sinuses relative to the body surface. An another endpoint is the need to explore the aortic root in the presence of interventricular communication and bicuspid aortic valve.
Highlights
Valsalva sinus aneurysms are heart abnormalities that can be acquired or congenital [1]
We report the observation of a child aged 7.5 years received in our department for the surgical management of an interventricular septal defect associated with a valsalva sinus aneurysm discovered in context of an asthmatic dyspnea with hyperactivity in the precordium
At the last echocardiography control, we found a bicuspid aortic valve with a tiny leak without stenosis, a medioventricular maximal gradient at 13mmHg
Summary
Valsalva sinus aneurysms are heart abnormalities that can be acquired or congenital [1]. In most cases, they are due to connective tissue abnormalities, infections, trauma or degenerative diseases. They are due to connective tissue abnormalities, infections, trauma or degenerative diseases These aneurysms are often asymptomatic and are diagnosed incidentally or when ruptured in nearby structures or when performing imaging tests for other indications [2]. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency due to the venturi effect, which often determines the prognosis [3]. Transcatheter closure has recently emerged as an alternative, less invasive treatment for patient population who are isolated sinus of valsalva aneurysm [4].
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