[Multiplane transesophageal echocardiography in the preoperative evaluation of the sinus of Valsalva fistula to right chambers].
OBJECTIVE
Ruptured sinus of Valsalva aneurysm to right cardiac chambers is an uncommon lesion in Western countries. The prognosis is usually serious unless the condition is promptly treated surgically. For this reason an accurate anatomical and functional evaluation is necessary. The main purpose of this report is to compare the usefulness of multiplane transesophageal echocardiography with transthoracic echocardiography and angiocardiography in the preoperative evaluation of ruptured sinus of Valsalva aneurysm to right chambers.


METHODS
Since January 1990, 9 patients (mean age 36,3 18 yr, 6 males) with ruptured sinus of Valsalva aneurysm to right chambers were studied. The pathogenesis was congenital aneurysm in 6 patients, aortic prosthesis endocarditis in one and two cases of iatrogenia: during a percutaneous mitral valvuloplasty and after cardiac surgery. Transthoracic echocardiography was performed in all cases, transesophageal echocardiography in 7 and angiocardiography in 8. Two patients died before surgery, and 7 were successfully operated on.


RESULTS
Transesophageal echocardiography was more useful when compared to transthoracic echocardiography and angiocardiography in detecting: a) the fistula; b) the sinus involved; c) the right chamber affected; d) congenital aneurysms morphology and size; e) aneurysm prolapse through a ventricular septal defect, y f) the identification of other cardiac congenital or acquired anomalies.


CONCLUSIONS
Multiplane TEE is the most accurate tool in the preoperative evaluation of ruptured sinus of Valsalva aneurysm to right chambers.
Garrido Martín
Ana
A
Unidad de Cardiopatías Congénitas del Adulto. Hospital Universitario La Paz. Madrid. agarridomar@hotmail.com
Oliver Ruiz
José M
JM
González
Ana E
AE
Mesa García
José M
JM
Benito
Fernando
F
Sobrino Daza
José A
JA
D000293:Adolescent; D000328:Adult; D000790:Angiocardiography; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012850:Sinus of Valsalva; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging*
Ecocardiografía transesofágica multiplana en la valoración preoperatoria de fístulas de senos de Valsalva en cavidades derechas.