title: Ruptured sinus of Valsalva aneurysm complicated by myocardial ischemia: pathogenetic mechanisms.
abstract: 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.
authors.affiliation: 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.
authors.forename: Lior
authors.initials: L
authors.lastname: Sasson
authors.affiliation: 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.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Katz
authors.affiliation: 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.
authors.forename: Tiberiu
authors.initials: T
authors.lastname: Ezri
authors.affiliation: Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Akiva
authors.initials: A
authors.lastname: Tamir
authors.affiliation: Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yoseph
authors.initials: Y
authors.lastname: Rozenman
authors.affiliation: Heart Institute, The Edith Wolfson Medical Center, Holon, Israel, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Geva
authors.affiliation: 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.
authors.forename: Arie
authors.initials: A
authors.lastname: Schachner
mesh_terms: 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