title: Complicated ruptured sinus of Valsalva: cardiac computed tomographic angiography (64 slice) predicts surgical appearance and obviates need for invasive cardiac catheterization.
abstract: We present a case report of a ruptured sinus of Valsalva aneurysm (SVA) that presented as aortic insufficiency following bacterial endocarditits in a cardiac transplant patient. Cardiac computed tomographic angiography (CCTA) including volume rendered images predicted the appearance of the fistula entrance and defined spatial relationships facilitating the surgical approach. CCTA ability to define the coronary anatomy obviated the need for invasive coronary angiography. The use of this imaging modality especially with three-dimensional spatial visualization, and multiphase cine angiography can add significant value to the care of a patient with ruptured sinus of Valsalva.
authors.affiliation: University of San Diego School of Medicine, San Diego, CA, USA.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Ro
authors.forename: Bruno R
authors.initials: BR
authors.lastname: Cotter
authors.forename: Sinan A
authors.initials: SA
authors.lastname: Simsir
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Karlsberg
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D002932:Cineangiography; D017023:Coronary Angiography / Q000379:methods*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation; D011237:Predictive Value of Tests; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology