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Review
. 2002;29(1):40-4.

Unruptured aneurysm of the left sinus of valsalva causing coronary insufficiency: case report and review of the literature

Antonio Lijoi  1 , Enrico Parodi, Gian Carlo Passerone, Flavio Scarano, Davide Caruso, Mario Vito Iannetti
Affiliations
Review

Unruptured aneurysm of the left sinus of valsalva causing coronary insufficiency: case report and review of the literature

Antonio Lijoi et al. Tex Heart Inst J. 2002.

Abstract

Aneurysm of the left sinus of Valsalva is extremely rare. Compression of the left coronary artery by such an aneurysm is an unusual complication of this condition and can cause coronary insufficiency. We describe the case of a 75-year-old woman who had an isolated unruptured aneurysm of the left coronary sinus with intraluminal thrombus, which caused coronary artery compression. We performed successful surgical correction by closing the mouth of the aneurysm without aortic valve replacement or coronary artery bypass grafting. A review of the world medical literature revealed 19 cases of sinus of Valsalva aneurysms that hindered the coronary arterial flow. The previously published reports of this rare condition and its treatment are discussed herein.

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Figures

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Fig. 1 Opacification of the aorta during left ventriculography shows a left sinus of Valsalva aneurysm (black arrows). The left main stem and the left anterior descending coronary artery are stretched and displaced upward (white arrows).
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Fig. 2 Selective angiogram of the left coronary artery shows the main trunk and the left anterior descending coronary artery (LAD) displaced upward. The proximal portion of the diagonal branch (Diag) is markedly compressed by the aneurysm.
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Fig. 3 Drawing shows the aneurysm of the sinus of Valsalva and the left coronary artery compression. An = aneurysm; Ao = aorta; Av = aortic valve; Lca = left coronary artery; Lv = left ventricle
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Fig. 4 Drawing shows the surgical treatment: the oval opening of the aneurysm is closed by horizontal sutures enforced with Teflon buttresses. Av = aortic valve; Lca = left coronary artery; Oan = opening of the aneurysm; Rca = right coronary artery
See this image and copyright information in PMC

References

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