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Case Reports
. 2019 Sep 6;11(9):e5589.
doi: 10.7759/cureus.5589.

Rupture of Sinus of Valsalva Aneurysm into Interventricular Septum: Role of Cardiac CT

Abhishek Jain  1 , Gayathri Achuthan  2
Affiliations
Case Reports

Rupture of Sinus of Valsalva Aneurysm into Interventricular Septum: Role of Cardiac CT

Abhishek Jain et al. Cureus. .

Abstract

Sinus of Valsalva aneurysm dissecting and forming sinus tract into interventricular septum is an extremely rare complication of sinus of Valsalva aneurysm. Echocardiography and conventional angiography were used earlier to diagnose ruptured sinus of Valsalva aneurysm. Cardiac CT has emerged as a valuable non-invasive diagnostic tool for evaluation of complications of sinus of Valsalva aneurysm. In this article, we report two cases of ruptured sinus of Valsalva aneurysm arising from right and left coronary sinuses into the interventricular septum without aorto-cardiac shunt formation evaluated using 256 slice cardiac CT imaging. After diagnosis on cardiac CT, these findings were confirmed perioperatively and were repaired surgically.

Keywords: aortic sinus; cardiac ct; coronary arteries; interventricular septum; ruptured sinus of valsalva aneurysm.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Cardiac CT (Axial view) demonstrates left sinus of Valsalva aneurysm (asterisk) with peripheral mural calcifications.
CT: Computed tomography; RV: Right ventricle; RA: Right atrium; LA: Left atrium; R: Right coronary sinus; L: Left coronary sinus; NC: Non-coronary sinus.
Figure 2
Figure 2. Cardiac CT (Axial view) demonstrates ruptured left sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow).
CT: Computed tomography; RV: Right ventricle; RA: Right atrium; LA: Left atrium.
Figure 3
Figure 3. Cardiac CT (sagittal oblique view) demonstrates ruptured left sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow) from the basal to mid septal region.
CT: Computed tomography; RV: Right ventricle; LV: Left ventricle.
Figure 4
Figure 4. Cardiac CT (3D VRT) demonstrates ruptured left sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow).
CT: Computed tomography; Curved arrow: Right coronary artery; RV: Right ventricle; LV: Left ventricle.
Figure 5
Figure 5. Cardiac CT (coronal oblique view) demonstrates ruptured left sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow) from the basal to mid septal region.
CT: Computed tomography; Curved arrow: Right coronary artery; Straight white arrow: Left coronary artery; RV: Right ventricle; LV: Left ventricle.
Figure 6
Figure 6. Intraoperative photography demonstrating the aneurysm (arrow) arising from the left sinus of Valsalva.
Figure 7
Figure 7. Cardiac CT (Axial view) demonstrates right (asterisk) and left (arrowhead) sinus of Valsalva aneurysms with right (curved arrow) and left (straight arrow) coronary arteries originating from them.
CT: Computed tomography.
Figure 8
Figure 8. Cardiac CT (coronal oblique view) demonstrates ruptured right sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow) and right coronary artery (curved arrow) originating from the aneurysm.
CT: Computed tomography; RV: Right ventricle; LV: Left ventricle.
Figure 9
Figure 9. Cardiac CT (sagittal oblique view) demonstrates ruptured right sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow) and prosthetic mitral valve.
CT: Computed tomography; RV: Right ventricle; LA: Left atrium; LV: Left ventricle.
Figure 10
Figure 10. Cardiac CT (sagittal oblique view) demonstrates ruptured right sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow).
CT: Computed tomography; RV: Right ventricle.
Figure 11
Figure 11. Cardiac CT (3D VRT) demonstrates ruptured right sinus of Valsalva aneurysm (asterisk) dissecting into the interventricular septum (black arrow).
CT: Computed tomography; RV: Right ventricle; Curved arrow: Right coronary artery; Straight white arrow: Left coronary artery.
Figure 12
Figure 12. Intraoperative photography demonstrating the aneurysm (arrow) arising from the right sinus of Valsalva.
See this image and copyright information in PMC

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