title: Adult aortic coarctation discovered incidentally after the rupture of sinus of Valsalva aneurysm: combined surgical and interventional approach.
abstract: Combination of ruptured sinus of Valsalva aneurysm (SVA), and a coexisting asymptomatic adult aortic isthmic coarctation is extremely rare. The timing and sequence of surgical and/or interventional repair of these two pathologies are controversial. We present a case of a 37-year-old male who was admitted to our department because of severe acute congestive heart failure and signs of ruptured aneurysm of the SV into the right ventricle. Transthoracic and transoesophageal echocardiography confirmed the communication between an important right coronary SVA and right ventricle, bicuspid aortic valve, mild aortic regurgitation, and revealed severe aortic coarctation. Because of the severe dilation of right sinus of Valsalva a surgical repair of the ruptured aneurysm was performed. Aortic coarctation was treated four weeks later by a percutaneous stent-graft implantation. This case report supports the concept that hybrid approach is feasible in patients with ruptured SVA and aortic coarctation in adulthood.
authors.affiliation: Department of Cardiology, Sahloul Hospital, Sousse, Tunisia. sanaouali@hotmail.fr
authors.forename: Sana
authors.initials: S
authors.lastname: Ouali
authors.forename: Chokri
authors.initials: C
authors.lastname: Kortas
authors.forename: Konrad
authors.initials: K
authors.lastname: Brockmeier
authors.forename: Essia
authors.initials: E
authors.lastname: Boughzela
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001019:Aortic Rupture / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D058070:Asymptomatic Diseases; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D033162:Incidental Findings; D008297:Male; D012850:Sinus of Valsalva / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures