title: Sinus of Valsalva aneurysm with rupture. Case report and literature review.
abstract: BACKGROUND
  The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its origin may be either acquired or congenital. The right coronary sinus is most frequently affected, with the most common complication being rupture.
  
  
  METHODS
  We report two cases of SVA complicated with rupture to the right cavities with severe cardiac failure, which represents 0.4% of the total cardiac surgeries performed during the past year in our hospital. Case #1: We present the case of a 27-year-old male with low-effort dyspnea, nocturnal paroxysmal dyspnea, orthopnea, paroxysmal atrial fibrillation, diastolic murmur, hepatomegaly and edema of the lower extremities. Case #2: We present the case of a 33-year-old male with low-effort dyspnea, nocturnal paroxysmal dyspnea, orthopnea, diastolic murmur, severe kidney insufficiency and congestive hepatic insufficiency. Surgical resolution in both cases consisted of aneurysm resection and closure of the defect with a Dacron patch, preserving the aortic valve. Both patients survived.
  
  
  CONCLUSIONS
  Cardiac failure and sudden auscultation changes suggest the possibility of SVA rupture. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion, rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short- and long-term.
authors.affiliation: Servicio de Cirugía Cardiotorácica, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico. mmygato@hotmail.com
authors.forename: Matilde Myriam
authors.initials: MM
authors.lastname: Galicia-Tornell
authors.forename: Bertha
authors.initials: B
authors.lastname: Marín-Solís
authors.forename: Oscar
authors.initials: O
authors.lastname: Mercado-Astorga
authors.forename: Saúl
authors.initials: S
authors.lastname: Espinoza-Anguiano
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-Martínez
authors.forename: Esteban
authors.initials: E
authors.lastname: Villalpando-Mendoza
mesh_terms: D000328:Adult; D001014:Aortic Aneurysm / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva