Two cases of ruptured congenital sinus of Valsalva aneurysms dissecting into the interventricular septum in patients with cerebral infarction

Abstract

Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.

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

“…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).…”