Ruptured sinus of Valsalva aneurysm complicated by myocardial ischemia: pathogenetic mechanisms.
Significant left-to-right shunt in combination with severe aortic regurgitation (AR) accelerates the development of symptoms after rupture of congenital sinus of Valsalva aneurysm (SVA) in spite of intact coronary arteries. We depict a rare description of a situation where acute coronary syndrome was the first manifestation of such an occurrence. We believe that the progress of the myocardial ischemia after ruptured SVA depends on the severity of AR and the quantity of the left-to-right shunt. Prompt recognition and surgical repair are indicated to prevent complications of myocardial infarction.
Sasson
Lior
L
Angela and Sami Shamoon Cardiothoracic Department, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Katz
Michael G
MG
Angela and Sami Shamoon Cardiothoracic Department, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ezri
Tiberiu
T
Department of Anesthesia, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Outcomes Research Institute, Louisville, KY, USA.
Tamir
Akiva
A
Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Rozenman
Yoseph
Y
Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Geva
Yoav
Y
Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Schachner
Arie
A
Angela and Sami Shamoon Cardiothoracic Department, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: dawn@wolfson.health.gov.il.
D001014:Aortic Aneurysm / Q000150:complications* / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications* / Q000601:surgery; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000601:surgery; D017202:Myocardial Ischemia / Q000209:etiology* / Q000601:surgery; D012850:Sinus of Valsalva / Q000473:pathology* / Q000601:surgery