Aneurysm and Fistula of the Sinus of Valsalva

Meyer, Joseph; Wukasch, Don C.; Hallman, Grady L.; Cooley, Denton A.

doi:10.1016/s0003-4975(10)63999-9

Cited by 72 publications

(13 citation statements)

References 5 publications

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“…As the aneurysms are frequently clinically silent, their exact prevalence is unknown, however an autopsy study of 8,138 individuals suggests a prevalence of 0.09% in the general population[ 13]. A family history is generally lacking, although Johnson et al described a case of two brothers with SVA that perforated into the right atrium[ 14]. SVA have a marked male preponderance (4:1) and their incidence is higher in Asian populations[ 15].…”

Section: Epidemiologymentioning

confidence: 99%

“…Hope described ‘a very loud, superficial sawing murmur prolonged continuously over the first and second heart sounds’[ 2]. The classic murmur is described in 40–95% patients presenting with an aneurysm, as a loud, machinery-like, continuous murmur, varying in intensity with systole and diastole, bestheard at the base of the heart[ 11, 14, 39]. The murmur does not peak around the second heart sound, as does the murmur of patent ductus arteriosus.…”

Section: Diagnosismentioning

confidence: 99%

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Aneurysms of the Sinuses of Valsalva

2006

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Sinus of Valsalva aneurysms are rare cardiac anomalies which may be acquired or congenital, most commonly involving the right or noncoronary sinuses. The congenital aneurysms are more common and often caused by weakness at the junction of the aortic media and the annulus fibrosus. Acquired aneurysms are caused by conditions affecting the aortic wall, such as infections (syphilis, bacterial endocarditis, or tuberculosis), trauma, or connective tissue disorders. Unruptured aneurysms are usually found incidentally during diagnostic studies. More commonly, sinus of Valsalvaaneurysms are diagnosed after clinical sequelae of rupture. Diagnosis of sinus of Valsalva aneurysm is facilitated by echocardiography, contrast aortography, and more recently, magnetic resonance imaging. Repair is generally required for ruptured aneurysms; unruptured aneurysms encroaching on nearby structures, causing myocardial ischemia, or having the potential to rupture warrant repair. A review of the literature is presented focusing on anatomy, clinical presentation of ruptured and unruptured aneurysms, noninvasive diagnostic modalities, and techniques for repair of this anomaly.

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Section: Epidemiologymentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Aneurysms of the Sinuses of Valsalva

2006

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“…It is usually possible to resect and repair most aneurysms. After repair, life expectancy is normal and the risk of recurrence is rare [3].…”

Section: Discussionmentioning

confidence: 99%

“…Reflux of contrast from left coronary artery injection demonstrated a large left sinus of valsalva aneurysm lying adjacent to the circumflex coronary artery (Figs. 2, 3).…”

Section: Case Reportmentioning

confidence: 99%

Sinus of valsalva aneurysm presenting as myocardial infarction during dobutamine stress test

Ferreira

Marchena

Mayor

et al. 1996

Cathet. Cardiovasc. Diagn.

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We report a patient with an undiagnosed left sinus of Valsalva aneurysm who, during a dobutamine stress test, had myocardial injury and subsequent infarction. Cardiac catheterization revealed an expanding sinus of valsalva aneurysm compressing the circumflex coronary artery. The clinical manifestations of sinus of Valsalva aneurysm are discussed. This report heightens awareness of the possible effects of the pharmacologic stress test. © 1996 Wiley‐Liss, Inc.

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“…'However, these aneurysms frequently rupture'9 and are often associated with aortic insufficiency in as many as 75 % of cases . 2,1,7,10,11,15,20 When this occurs patients usually present with murmurs 12 or symptoms of congestive heart failure, chest pain or palpitations. Few authors have tried to relate the degree of left-to-right shunt or aortic insufficiency to symptoms or Functional Class.3 Symptoms may also be related to associated defects which are frequently found in patients with sinus of Valsalva aneurysm.…”

Section: Introductionmentioning

confidence: 99%

Aneurysm of the Aortic Sinuses of Valsalva: Hemodynamics and Long-Term Prognosis After Surgery

et al. 1984

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Seventeen patients with sinus of Valsalva aneurysm are described. All of these patients have had late follow-up to assess prognosis. Twelve patients had congenital aneurysms and five were mycotic. There were 12 males and five females, ranging in age from 20 to 59 years of age (mean of 38 years). Symp toms of congestive heart failure, fatigue, and palpitations were common and were present from three days to seven years before diagnosis (mean of 13.8 months.) All patients had cardiac catheterization including aortography, and 16 had right heart catheterizations. Eleven patients (65%) had aneurysms which ruptured into another cardiac chamber, most frequently the right atrium (six patients). Eleven patients (65%) had aortic insufficiency, and it was moderate to severe in seven. New York Heart Association (NYHA) Functional Class at diag nosis was variable and did not correlate with degree of left-to-right shunt in patients with fistulas to the right heart. Functional Class seemed to correlate with the degree of aortic insufficiency. Fourteen patients required surgery. The surgical procedure usually con sisted of repair of aneurysm and fistula when present, and aortic valve replace ment. There was one death prior to surgery and one operative death (operative mortality of 7%). Ten of the patients (66%) were in NYHA Functional Class I at late follow-up (range 2.5 to 13.1 years, mean 6.5 years). Long-term functional disability occurred more frequently in patients with moderate to severe aortic insufficiency at the time of diagnosis. Patients with aneurysm of the sinus of Valsalva are a heterogenous popula tion. Functional Class at the time of diagnosis as well as long-term prognosis appears to be related to the presence and severity of aortic insufficiency at diagnosis. Catheterization with aortography and right heart catheterization are mandatory for accurate diagnosis. Surgical results are good with low operative mortality and improvement in long-term Functional Class.

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Aneurysm and Fistula of the Sinus of Valsalva

Cited by 72 publications

References 5 publications

Aneurysms of the Sinuses of Valsalva

Aneurysms of the Sinuses of Valsalva

Sinus of valsalva aneurysm presenting as myocardial infarction during dobutamine stress test

Aneurysm of the Aortic Sinuses of Valsalva: Hemodynamics and Long-Term Prognosis After Surgery

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