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Case Reports
. 2024 Mar 15;63(6):829-832.
doi: 10.2169/internalmedicine.1395-22. Epub 2023 Aug 9.

Ruptured Sinus of Valsalva Aneurysm in a Patient with a Ventricular Septal Defect Who Dropped Out of Lifelong Medical Follow-up

Yusuke Morii  1 , Hiroaki Morinaga  1 , Ken Kato  1 , Motoyuki Hisagi  2 , Hiroyuki Tanaka  1
Affiliations
Case Reports

Ruptured Sinus of Valsalva Aneurysm in a Patient with a Ventricular Septal Defect Who Dropped Out of Lifelong Medical Follow-up

Yusuke Morii et al. Intern Med. .

Abstract

Ruptured sinus of Valsalva aneurysm (RSOVA) is a rare cardiac condition associated with high morbidity and mortality rates. We herein report a 35-year-old man with a history of ventricular septal defect (VSD). He had a history of interrupted hospital visits and presented to the emergency department with dyspnea, palpitations, and dizziness for a few days. Auscultation detected a continuous murmur. Transthoracic echocardiography followed by transesophageal echocardiography demonstrated RSOVA in the right ventricle with an aorto-right ventricular fistula. The fistula was resected, and the aneurysm was surgically repaired. The patient made a good recovery.

Keywords: continuous murmur; ruptured sinus of Valsalva aneurysm; ventricular septal defect.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Transthoracic echocardiography (TTE). Parasternal long-axis views in systole (A) and diastole (B) demonstrated focal protrusion of the right coronary sinus with a continuous left-to-right flow on Doppler color-flow imaging. RV: right ventricle, LV: left ventricle, SOV: sinus of Valsalva, Ao: aorta
Figure 2.
Figure 2.
A transesophageal echocardiogram (TEE). Mid-esophageal RV inflow-outflow view in systole (A) and diastole (B) demonstrated focal protrusion of the right coronary sinus with continuous left-to-RVOT on Doppler color-flow imaging. AoVO: aortic valve orifice, RVOT: right ventricular outflow tract
Figure 3.
Figure 3.
Computed tomography demonstrated intravenous contrast in the communication between the aortic root and RVOT (arrow). RVOT: right ventricular outflow tract, Ao: aorta, SOV: sinus of Valsalva, LV: left ventricle
Figure 4.
Figure 4.
A: VSD is demonstrated at surgery (asterisk). B: RSOVA is demonstrated at surgery (yellow arrow). C, D: The black star arrows point to the patch used to repair the RSOVA, and the yellow star arrow indicates the patch used to fix the VSD. AoVO: aortic valve orifice, PVO: pulmonary valve orifice
See this image and copyright information in PMC

References

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