title: The role of multi-modality imaging for sinus of Valsalva aneurysms.
abstract: Sinus of Valsalva aneurysms (SVAs) are uncommon but important entities. They are most often congenital in origin, resulting from incomplete fusion of the aortic media to the aortic valve annulus. Less frequently, they may be acquired, usually secondary to infective endocarditis. Unruptured aneurysms may be clinically silent and diagnosed incidentally, but can also produce symptoms as a consequence of mass effect on related structures. Rupture may present with sudden hemodynamic collapse but can have a more insidious onset depending upon the site and size of the perforation. Early diagnosis is imperative and can usually be made reliably by transthoracic echocardiography. However, transesophageal echocardiography may sometimes be required for confirmation. Cardiovascular magnetic resonance imaging (CMRI) and multi-detector computed tomography are being increasingly utilized for evaluation of SVAs and can offer valuable complimentary information. CMRI in particular enables a comprehensive assessment of anatomy, function and flow in a single sitting. Surgical repair forms the mainstay of treatment for both ruptured and unruptured aneurysms and has low complication rates. This article provides an overview of the pathological and clinical aspects of SVAs and discusses in detail the role of advanced imaging modalities in their evaluation.
authors.affiliation: Department of Radiology, Heartlands Hospital, Heart of England NHS Trust, Bordesley Green East, Birmingham, B9 5SS West Midlands, UK. edwardhoey1@gmail.com
authors.forename: Edward T D
authors.initials: ET
authors.lastname: Hoey
authors.forename: Gurpreet Singh
authors.initials: GS
authors.lastname: Gulati
authors.forename: Sandeep
authors.initials: S
authors.lastname: Singh
authors.forename: Richard W
authors.initials: RW
authors.lastname: Watkin
authors.forename: Sarfraz
authors.initials: S
authors.lastname: Nazir
authors.forename: Arul
authors.initials: A
authors.lastname: Ganeshan
authors.forename: Abrar
authors.initials: A
authors.lastname: Rafique
authors.forename: Mohan U
authors.initials: MU
authors.lastname: Sivananthan
mesh_terms: D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006801:Humans; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging / Q000473:pathology