Aneurysm of the left sinus of valsalva causing aortic, mitral regurgitation and myocardial ischemia

Abstract

An aneurysm of the left sinus of Valsalva producing aortic and mitral regurgitation with myocardial ischemia was treated successfully by reconstructing the left coronary sinus while preserving the aortic cusp combined with coronary artery bypass grafting. Aortic and mitral regurgitation occurred due to distortion of the left aortic cusp by a huge aneurysm that also compressed and obstructed the main trunk of the left coronary artery. The postoperative course was uneventful and follow-up showed aortic and mitral regurgitation to be absent and the coronary graft to be patent. Aortic valve-sparing surgery thus proved to be an appropriate procedure for this case.

Clinical outcomes of combined aortic root replacement with mitral valve surgery

“…5,12 There have been case reports of patients with aortic root aneurysm in whom mitral regurgitation developed because of distortion of the anterior leaflet of the MV. 13,14 In the present series, all patients had intrinsic MV disease (Table 2).…”

Aortic Valve Reconstruction: Why, When, and How?

“…Valve resuspension techniques are simplified techniques developed to avoid the necessity of excising and reimplanting the coronary ostia. Redundant wall tissue of the sinus wall can be resected and the remaining halves reattached [57] or the sinuses are simply plicated to reduce the outwardly bulging area. As such measures are mostly applied to the noncoronary sinus, a modification of all three sinuses can be accomplished with U-shaped and J-shaped reduction plasty [58].…”

“…The repaired aortic root can then be anastomosed with an appropriately sized prosthesis while ensuring correct triangular positioning of the commissures. Apart from glue repair, an isolated dissection of the noncoronary sinus can be treated by means of resection and reconstruction utilizing an otherwise supracommissural graft with a single tongue fitting into the resected sinus [57]. 4.…”