Rare incidental findings of large congenital subvalvular aortic aneurysm in asymptomatic adults: To operate or not to operate? So far from lightness

Abstract

With regard to the recently published case image, 1 the present opinion essay aims at highlighting the blind spots of the topic, given the rarity, limited evidence, and potential lethality of large subvalvular aortic aneurysm (SAA).SAA is an underdiagnosed entity, thus the incidence of both SAA and associated anomalies are unknown. 2 SAA is usually diagnosed in young adults, less frequently in children, 3 being extremely rare in older adults.Potential complications of SAA may be related to its peculiar anatomy and etiology, dimensions, and extremely variable localization. In adults, SAA may be both acquired or congenital affection. The former is mainly secondary to trauma, cardiac surgery, or infections, and frequently appears as a pseudoaneurysm with a fibrous lining, often associated with a narrow neck: 2 the spontaneous rupture and sudden death have been reported, 2,3 thus surgical approach is generally recommended.