[Ruptured aneurysm of sinus of Valsalva into the right atrium with aortic valve perforation].
A 58-year-old female was admitted to our hospital because of sudden dyspnea and general malaise. A continuous murmur was heard along the left sternal border. A chest X-ray showed cardiomegaly and pulmonary vascular marking. Doppler echocardiography confirmed the presence of an aneurysmatic mass, originating from the non-coronary sinus of Valsalva and extending to the right atrium, with a turbulent flow into the right atrium, aortic regurgitation (II/IV) and tricuspid regurgitation (III/IV). Ascending aortography demonstrated a communication between the aortic sinus and the right atrium. The pulmonary-to-systemic flow ratio was calculated to be 2.04. Oblique aortotomy and right atriotomy were performed. The aneurysm was resected and its origin was directly closed with horizontal mattress sutures through the aortic side and right atrial side. Perforation of a non-coronary cusp that caused aortic regurgitation was found following aortotomy and it was closed with an autologous pericardial patch. Tricuspid annuloplasty was performed using DeVega's technique. The postoperative course was uneventful, and she was discharged on the 10th postoperative day.
Watanabe
A
A
Department of Surgery, Sunagawa City Hospital, Sunagawa, Japan.
Sasaki
A
A
Hirabayashi
T
T
Itoh
M
M
Abe
T
T
D001019:Aortic Rupture / Q000150:complications / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006325:Heart Atria; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D012422:Rupture, Spontaneous; D012850:Sinus of Valsalva; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery