[Perioperative management of a ruptured sinus of Valsalva aneurysm].
Congenital sinus of Valsalva aneurysms are extremely rare in Spain. The lesion consists of a defect that allows the aortic media to separate from the annulus fibrosus of the aortic valve, causing it to dilate with arterial pressure. The natural course of the aneurysm involves the risk of complication due to bacterial endocarditis, with conduction blocks or myocardial ischemia. Rupture of the aneurysm, usually into a right chamber, causes a left-right shunt that leads to heart failure and death if untreated. We present the case of a previously asymptomatic 60-year-old woman who presented with a clinical picture that led to a diagnosis of hyperthyroidism, and in whom there occurred a coincident rupture of a congenital sinus of Valsalva aneurysm. We describe the anesthetic procedure and emphasize the importance of intraoperative echocardiography throughout the resection of the aneurysm.
Peña
J J
JJ
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia. juanjopborras@yahoo.es
Marqués
J I
JI
Mateo
E
E
Llagunes
J
J
Aguar
F
F
de Andrés
J
J
D000768:Anesthesia, General / Q000379:methods; D013956:Antithyroid Agents / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000150:complications / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D018880:Atrial Premature Complexes / Q000209:etiology; D019320:Embolism, Paradoxical / Q000517:prevention & control; D005260:Female; D005402:Fistula / Q000150:complications / Q000000981:diagnostic imaging; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008875:Middle Aged; D011229:Preanesthetic Medication; D011433:Propranolol / Q000008:administration & dosage / Q000627:therapeutic use*; D012422:Rupture, Spontaneous; D012850:Sinus of Valsalva / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D013616:Tachycardia, Sinus / Q000188:drug therapy / Q000209:etiology; D018084:Ultrasonography, Interventional
D013956:Antithyroid Agents; D011433:Propranolol