Abstract
Sinus of Valsalva aneurysm is a rare congenital or acquired aortic root anomaly. The aneurysm has the potential to compress the adjacent structures or rupture to other cardiac chambers with fatal consequences. Patients might be asymptomatic or present with nonspecific cardiac symptoms. Once the diagnosis is made, prompt surgical repair is generally required. Here, we present a young woman with frequent syncope who was found to have a giant sinus of Valsalva aneurysm as the underlying etiology.
Keywords
A 36-year-old female presented to our emergency department with frequent syncopal attacks. In physical examination, there was mildly decreased oxygen saturation in room air of 91%. In echocardiography and computed tomographic angiogram, the aortic valve had asymmetric annular dilatation and a huge aneurysm formation in the non-coronary cusp measuring about 7 cm × 6.6 cm. The aneurysm had no evidence of rupture to adjacent chambers but had critically compressed the right atrium and the tricuspid valve (Figure 1 and Figure 2). The patient underwent urgent surgery. The non-coronary sinus was reconstructed by placing a pericardial patch between the annulus and the ascending aorta that excluded the aneurysm from the non-coronary cusp. The remaining parts of the aneurysm tissue were closed over the reconstructed sinus (Figure 3). Patient's postoperative course was uneventful, and syncopal attacks were resolved. The oxygen saturation was normalized to 94% at room air. Transthoracic echocardiography one month after the surgery showed satisfactory results and no complications.
Transthoracic echocardiogram in short axis (A) and long axis views depicting the huge aneurysm of the non-coronary cusp of the aorta (star). Transesophageal echocardiogram showing the aneurysm with a smoky pattern and impending clot formation (C). AO, aorta; LV, left ventricle; RVOT, right ventricular outflow tract.
Multiplanar reconstruction in coronal (A) and axial (B) CT-angiogram views showing the giant non-coronary cusp aneurysm (arrow). AO, aorta; LV, left ventricle; RV, right ventricle; RA, right atrium.
Perioperative view of the aneurysmal non-coronary cusp of aorta (A, arrow). Exclusion of the aneurysm from aortic root by pericardial patch (B, arrow).
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Ethical approval
Ethics committee approved of the study protocol (committee's reference number: 01022).
Informed consent
Written patient consent was obtained.
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