Aneurysm Of Noncoronary Sinus Of Valsalva Research Articles

Sinus of Valsalva Aneurysm in Females.

Sinus of Valsalva aneurysm (SVA) is a rare cardiovascular disease with male predominance. Recently, an association with aortic aneurysm and SVA has been revealed in periventricular nodular heterotopia patients with loss-of-function Filamin A (FLNA) mutations, which were located on chromosome X and almost exclusively affect females.Among patients hospitalized for aortic surgery with aortic root diameter over 4.0 cm, next-generation sequencing was performed to investigate 30 candidate genes related to inherited aortic aneurysm syndromes and familial thoracic aortic aneurysm and dissection. The present report reviewed an electronic case database and identified two female cases of unruptured SVA with heterozygous FLNA truncating mutations.Case 1 displaying a rare SVA phenotype involving left and noncoronary sinus harbored a nonsense variant p.Tyr1720Ter/c.5160C > G. Case 2 displayed right and noncoronary SVA with predominantly enlarged right coronary sinus, posterior mitral valve prolapse, and harbored a frameshift variant p.Val1724fs*68/c.5171_5172delTG. Both novel mutations resulted in the premature termination of filamin A with the loss of functional Rod 2 and dimerization region.The present report raised the possibility of the presence of a cardiovascular onset form in the spectrum of FLNA hereditary diseases. The association between SVA and loss-of-function FLNA mutations indicates a unique etiology and pathogenesis among female patients, which requires further investigation to establish the linkage between FLNA variants and a wide spectrum of phenotypes.

Rupture of Non-coronary Sinus of Valsalva Aneurysm Contained by Ventricular Wall: A Case Report

Sinus of Valsalva aneurysm is a typically asymptomatic, rare cardiac pathology that is defined as a dilation of a sinus of the aorta. If large enough, the patient may present with symptoms reflective of dysfunction of adjacent structures caused by compressive effect. Sinus of Valsalva aneurysms have high rate of morbidity and mortality in the rare event that they rupture. Consequences of aneurysmal rupture vary depending on which sinus is affected and the location of the aneurysm. Contained aneurysms of this type have rarely been reported. Early surgical intervention is indicated for symptomatic aneurysms and aneurysmal rupture. We present a case of a contained rupture of the non-coronary sinus of Valsalva aneurysm and demonstrate the need to maintain a high index of suspicion in asymptomatic patients who have risk factors for the development of this type of aneurysm.

A Giant Ruptured Noncoronary Sinus of Valsalva Aneurysm: A Case Report

The occurrence of a giant ruptured aneurysm originating from the noncoronary sinus of Valsalva in the right atrium is extremely rare. Herein, a case is presented of a giant ruptured noncoronary sinus of Valsalva aneurysm (SVA) that was protruding into the right atrium, which was almost completely occupied by an aneurysm. A 61-year-old female was referred to the hospital for exertional palpitation and dyspnea. While a surgical repair was performed by resection of the aneurysm and a sinus remodeling with a patch of fresh bovine pericardium, a very rare case was observed. It was a giant ruptured noncoronary sinus of aneurysm that completely occupied the right atrium, which was difficult to distinguish from the coronary aneurysm. It is also believed that various imaging examinations, such as cardiac computed tomography angiogram (CCTA) and transthoracic echocardiogram (TTE), were useful for the diagnosis.

Ruptured Sinus of Valsalva Aneurysm

Sinus of Valsalva Aneurysms are extremely rare cardiac anomalies.The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its may be either acquired or congenital. The right coronary sinus is most frequently affected. The most common complication being rupture.We present the case of a 12-year old girl with ruptured non-coronary sinus of valsalva aneurysm associated with ventricular septal defect , mitral regurgitation grade II and severe pulmonary hypertension. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion,rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short- and long-term.
 KYAMC Journal Vol. 10, No.-4, January 2020, Page 211-213

Impact of Intraoperative Transesophageal Echocardiography for Noncoronary Sinus of Valsalva Aneurysm With Severe Tricuspid Regurgitation

Abstract Congenital non-coronary sinus of Valsalva aneurysm is a rare finding and associated complicating pathologies can include tricuspid stenosis (TS) and tricuspid regurgitation (TR) in unruptured aneurysms. However, there are few reports to analyze those pathologies with intraoperative transesophageal echocardiography (TEE). We report a case of non-coronary sinus of Valsalva aneurysm who underwent patch repair. Intraoperative TEE provided additional information of severe TR worsened by the restriction of the anterior tricuspid leaflet motion due to the aneurysm, and it was successfully repaired with tricuspid ring annuloplasty. Multimodal assessment using intraoperative TEE was useful for detecting pathophysiological features of noncoronary sinus of Valsalva aneurysm and associated tricuspid valve lesion, and decision making for additional procedures.

Unruptured non-coronary sinus of Valsalva aneurysm – case report

Unruptured non-coronary sinus of Valsalva aneurysm – case report

Ruptured Sinus of Valsalva Aneurysm into the Left Atrium with Multiple Fistulous Communications: A Rare Cause of Heart Failure.

Ruptured noncoronary sinus of valsalva aneurysm with fistulous connections to multiple cardiac chambers has not been reported previously. We report a 66-year-old man who presented with worsening cough and exertional dyspnea. Transesophageal echocardiogram confirmed a large aneurysm involving the noncoronary cusp of the aortic sinus with aneurysmal extension to the left atrium. There were also two fistulous communications with the left atrium and one small fistulous connection with the right atrium. Open-heart surgery with aortic root replacement and reimplantation of coronary arteries along with primary closure and repair of aorta to the left atrial fistula was performed.

右房穿破により急性心不全を発症した Valsalva 洞動脈瘤の1治験例

右房穿破により急性心不全を発症した Valsalva 洞動脈瘤の1治験例

Rupture of a Noncoronary Sinus of Valsalva Aneurysm into the Left Atrium: A Rare Cause of Acute Pulmonary Edema

A sinus of Valsalva aneurysm is a dilatation of the aortic wall caused by the lack of continuity between the middle layer of the aortic wall and the aortic valve. It has an incidence of <0.1%. The most common cause of a sinus of Valsalva aneurysms is congenital, although they may also be acquired. The most common complication is rupture into the right atrium or ventricle, with rupture into the left chambers occurring very rarely. We present a 40-year-old man admitted to the hospital with an acute onset of respiratory distress and pleuritic chest pain. Transthoracic echocardiography followed by transesophageal echocardiography showed rupture of a noncoronary aneurysm of Valsalva sinus into the left atrium. The jet from the fistula caused retrograde flow into the pulmonary veins.

Sinus of Valsalva Aneurysm

63-year-old man was in good health with well-controlled hypertension and dyslipidemia when he developed progressive dyspnea one day following an uncomplicated and unrevealing routine screening colonoscopy. Physical examination, electrocardiogram, and chest radiograph revealed hypotension, tachycardia, jugular venous distension, cardiomegaly, grade III/VI holosystolic murmur at the apex, and bilateral basilar pulmonary rales. Laboratory investigation disclosed mild troponemia, azotemia, elevated brain natriuretic peptide, and elevated acute-phase reactants. Echocardiography revealed an unruptured noncoronary sinus of Valsalva aneurysm (SVA) protruding into the left atrium, obstructing mitral outflow while also causing acute severe mitral regurgitation (Figure ​(Figure11). Figure 1 Preoperative echocardiogram: (a) two-dimensional apical four-chamber view, (b) same view with color flow. SVAs are exceedingly rare congenital or acquired degenerations of connective tissue from atherosclerosis, infection, or trauma resulting in dilations of one of three aortic sinuses: most commonly right, occasionally noncoronary, and rarely left. Unruptured SVAs are usually clinically silent and found incidentally during routine echocardiography. Occasionally, the physical presence of SVAs can precipitate arrhythmias, obstruct a coronary artery resulting in myocardial ischemia, or disrupt normal hemodynamics. Ruptured SVAs have a varied presentation, ultimately depending on the size, progression, and chamber into which rupture occurs. Surgical correction is indicated for ruptured SVAs and unruptured SVAs of large size and those with complications, including but not limited to altered hemodynamics or conduction abnormalities (1). Our patient presented with uncompensated New York Heart Association class III–IV heart failure and was medically stabilized. He then underwent aneurysm resection followed by valve-sparing patch repair of the aortic root along with mitral valve repair with an annuloplasty ring. The patient is currently symptom free 12 months postoperatively following uncomplicated surgical correction (Figure ​(Figure22). Figure 2 Postoperative echocardiogram: two-dimensional apical four-chamber view.

A Case with Noncoronary Sinus of Valsalva Aneurysm: Multidetector Computed Tomography Findings

We report the case of a 23-year-old man with an unruptured noncoronary sinus of Valsalva aneurysm and Marfan syndrome, which were diagnosed by 16-row multidetector computed tomography (MDCT). MDCT has enabled imaging of the cross-sectional anatomy of the heart with excellent spatial and temporal resolution that reflects the anatomical and functional changes in cardiac pathologies. Thus, the knowledge of the CT anatomy of the heart has become increasingly important for radiologists. This report aimed to confirm the contribution of MDCT in establishing the diagnosis and to show the potential association of nodular septation in the noncoronary sinus of Valsalva with aneurysm.

An Unusual Cause of Pulmonary Edema: Acute Rupture of Noncoronary Sinus of Valsalva Aneurysm into the Left Atrium

We present the case of a patient admitted to hospital with pulmonary edema and atrial fibrillation. The transthoracic echocardiogram showed noncoronary sinus of Valsalva aneurysm ruptured into the left atrium, with a turbulent flow directed toward the left atrium floor and the pulmonary vein, which explained the clinical presentation. Echocardiography played a crucial role in identification of the cause and correct therapeutic approach.

Issue Highlights

HomeCirculationVol. 110, No. 22Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published30 Nov 2004https://doi.org/10.1161/circ.110.22.3399Circulation. 2004;110:3399SHORT-TERM EFFECTS OF RIGHT-LEFT HEART SEQUENTIAL CARDIAC RESYNCHRONIZATION IN PATIENTS WITH HEART FAILURE, CHRONIC ATRIAL FIBRILLATION, AND ATRIOVENTRICULAR NODAL BLOCK, by Hay et al.Although the hemodynamic and clinical benefits of biventricular pacing have been demonstrated in patients with heart failure, it has not been clear whether there is additional benefit from sequential pacing of the ventricles. Prior studies of this issue may have been confounded by the effects of concomitant supraventricular activation and atrial contraction. Hay and colleagues avoided this problem by studying the acute hemodynamic effects of right ventricular, left ventricular, and biventricular pacing with simultaneous or sequential activation in 9 patients with atrial fibrillation and high-grade atrioventricular nodal blockade. They found that biventricular pacing was superior to pacing either the left ventricle or right ventricle alone and that simultaneous activation of the right ventricle and left ventricle resulted in the optimal improvement in systolic and diastolic function. See p 3404.ONE-YEAR CORONARY BYPASS GRAFT PATENCY: A RANDOMIZED COMPARISON BETWEEN OFF-PUMP AND ON-PUMP SURGERY: ANGIOGRAPHIC RESULTS OF THE PRAGUE-4 TRIAL, by Widimsky et al.The controversy about whether off-pump coronary artery bypass surgery (CABG) is superior to on-pump CABG continues to be evaluated. In the report by Widimsky et al, a cohort of patients from a randomized trial (PRAGUE-4) of off-pump CABG versus on-pump CABG underwent cardiac catherization at one year. Patency of arterial grafts (left internal mammary artery to the left anterior descending) was excellent and similar in both groups, but fewer saphenous vein grafts per patient were patent in the off-pump group. This study raises the concern that the perceived benefits of off-pump CABG may lead to poor late outcomes because of a reduction in graft patency. See p 3418.CHILDHOOD ADIPOSITY AS A PREDICTOR OF CARDIAC MASS IN ADULTHOOD: THE BOGALUSA HEART STUDY, by Li et al.Li and colleagues examined the association of left ventricular mass in young adults with longitudinal measurements of risk factors from childhood, with an average follow-up period of 21.5 years. Adiposity (measured as body mass index) in childhood, in adulthood, or as a cumulative burden since childhood was the most consistent predictor of left ventricular mass (indexed to height2.7) in young adults. In addition, systolic blood pressure measured in adulthood or as a cumulative burden since childhood was also an independent predictor. These findings underscore the importance of obesity beginning in childhood in the development of left ventricular hypertrophy, as well as the need for early intervention. See p 3488.Visit www.circ.ahajournals.org:Images in Cardiovascular MedicineGiant Unruptured Noncoronary Sinus of Valsalva Aneurysm. See p e515.Percutaneous Replacement of the Pulmonary Valve in a 12-Year-Old Child. See p e516.Download figureDownload PowerPointDownload figureDownload PowerPoint Previous Back to top Next FiguresReferencesRelatedDetails November 30, 2004Vol 110, Issue 22 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.110.22.3399 Originally publishedNovember 30, 2004 PDF download Advertisement

Unruptured Noncoronary Sinus of Valsalva Aneurysm: Preoperative Characterization by Transesophageal Echocardiography

We describe a patient with a large unruptured sinus of Valsalva aneurysm that was discovered incidentally. Transesophageal echocardiography was used to characterize the aneurysm preoperatively, and was helpful intraoperatively in assessment of the degree of native aortic valvular regurgitation after repair. The use of transthoracic echocardiography, contrast echocardiography, Doppler echocardiography, and transesophageal echocardiography are discussed in this condition.