title: Comprehensive imaging including three-dimensional echocardiography of an infected, ruptured sinus of valsalva aneurysm.
abstract: A 30-year-old man presented with fevers and fatigue. Blood cultures grew Streptococcus mitis in 4/4 bottles. Transthoracic three-dimensional echocardiography revealed an anterior coronary sinus of Valsalva (SOV) aneurysm with fistula formation into the right ventricle with vegetation on the fistulous tract, and a bicuspid aortic valve without vegetation. Transesophageal echocardiography confirmed these findings. After parenteral antibiotic treatment, the patient went for successful repair of the fistula, with the imaging findings confirmed at surgery. This case represents a rare complication of a ruptured SOV aneurysm, with excellent delineation of cardiac anatomy using transthoracic three-dimensional echocardiography.
authors.affiliation: Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Hector M
authors.initials: HM
authors.lastname: Medina
authors.forename: Jacobo
authors.initials: J
authors.lastname: Vazquez
authors.forename: Allison
authors.initials: A
authors.lastname: Pritchett
authors.forename: Nasser
authors.initials: N
authors.lastname: Lakkis
authors.forename: Hisham
authors.initials: H
authors.lastname: Dokainish
mesh_terms: D000328:Adult; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D001019:Aortic Rupture / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D012850:Sinus of Valsalva