title: Right aortic sinus of Valsalva-to-right ventricle fistula complicating bacterial endocarditis of membranous ventricular septal defect: evaluation by two-dimensional, color flow, and Doppler echocardiography.
abstract: Rupture of the aortic sinus of Valsalva into the right ventricle is a rare complication of bacterial endocarditis. The majority of previous cases have been reported in patients with aortic valve endocarditis. This report describes this complication in association with infective endocarditis of a congenital membranous ventricular septal defect. Color flow imaging showed a mosaic-colored continuous flow signal from the right aortic sinus to the right ventricle. Continuous wave Doppler interrogation showed high-velocity systolic and diastolic flow signals due to continuous left-to-right shunt from the aorta to the right ventricle. The left-to-right shunt through a restrictive membranous ventricle septal defect was visualized as a mosaic-colored high-velocity systolic flow signal. These echocardiographic-Doppler findings permitted surgical correction of these defects without cardiac catheterization.
authors.affiliation: Department of Medicine, Loma Linda University Medical Center, CA 92350.
authors.forename: R C
authors.initials: RC
authors.lastname: Bansal
authors.forename: K M
authors.initials: KM
authors.lastname: Wangsnes
authors.forename: L
authors.initials: L
authors.lastname: Bailey
mesh_terms: D000328:Adult; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging; D013203:Staphylococcal Infections / Q000150:complications