Surgical Repair of Postoperative Left Sinus of Valsalva Aneurysm Dissecting Into the Interventricular Septum

Aneurysm of Sinus of Valsalva Dissecting Into the Interventricular Septum After Aortic Valve Replacement: Diagnosis by Echocardiography and Magnetic Resonance Imaging and Treatment With Surgical Sealant

“…Congenital ASVs are more common than acquired ASVs 6). Acquired ASVs are caused by conditions affecting the aortic wall, such as infections (bacterial endocarditis, syphilis, or tuberculosis); chest trauma; or degenerative diseases (atherosclerosis, connective tissue diseases, or cystic medical necrosis) 3)4)11-14).…”

“…Acquired ASVs are caused by conditions affecting the aortic wall, such as infections (bacterial endocarditis, syphilis, or tuberculosis); chest trauma; or degenerative diseases (atherosclerosis, connective tissue diseases, or cystic medical necrosis) 3)4)11-14). Complications of ASV include arrhythmia, atrioventricular block, obstruction of ventricular outflow tract, aortic insufficiency, congestive heart failure, and multidirectional rupture with embolic event, with the most common complication being atrioventricular conduction disturbance among the reported cases 5)6)13)18)19). Dissection of the interventricular septum is a very rare complication of sinus of Valsalva aneurysm, in which case the interventricular septum is dissected and forms an aneurysm which bulges into both the left and right ventricles, causing obstruction of both ventricular outflow tracts 4).…”

“…In this case, the cause of aneurysm formation with dissection into the interventricular septum is presumed to be the postoperative shear stress due to turbulent flow against the weak tissue between the interventricular septum and the prosthetic aortic valve. In addition, direct pressure by the expanding aneurysm is considered responsible for atrioventricular dissociation and various types of bundle branch blocks 6). Furthermore, evidence of hemorrhage and low-grade inflammatory changes in conduction tissues present near the aneurysm are possible causes of conduction disturbances 16).…”

“…Surgical management strategies, which include plication of fistula opening, patch repair, and aortic root replacement, especially in the presence of aortic valvular disease, should be tailored to the needs of each patient 4). Calcification of the aneurysmal wall may provoke unfavorable effects, including difficulty of direct suturing of the orifice and the late risk of dehiscence 6). In such a situation, aneurysm resection may not only be time consuming but hazardous.…”

Rupture of Sinus of Valsalva Aneurysm (Type V Sakakibara Type) Treated by the Amplatzer Pda Occluder Device

“…It is due to the direct pressure effects or adjacent low-grade inflammatory reaction [13]. Heart block and various degrees of bundle branch block have been also been reported [7].…”