title: Ruptured Sinus of Valsalva Aneurysm into the Left Atrium with Multiple Fistulous Communications: A Rare Cause of Heart Failure.
abstract: Ruptured noncoronary sinus of valsalva aneurysm with fistulous connections to multiple cardiac chambers has not been reported previously. We report a 66-year-old man who presented with worsening cough and exertional dyspnea. Transesophageal echocardiogram confirmed a large aneurysm involving the noncoronary cusp of the aortic sinus with aneurysmal extension to the left atrium. There were also two fistulous communications with the left atrium and one small fistulous connection with the right atrium. Open-heart surgery with aortic root replacement and reimplantation of coronary arteries along with primary closure and repair of aorta to the left atrial fistula was performed.
authors.affiliation: Department of Internal Medicine/Pediatrics and Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI 49048, USA.
authors.forename: Yashwant
authors.initials: Y
authors.lastname: Agrawal
authors.affiliation: Department of Internal Medicine/Pediatrics and Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI 49048, USA.
authors.forename: Rakshita
authors.initials: R
authors.lastname: Chandrashekhar
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, Borgess Medical Center, Kalamazoo, MI 49048, USA.
authors.forename: Jerry W
authors.initials: JW
authors.lastname: Pratt
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, Borgess Medical Center, Kalamazoo, MI 49048, USA.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Cole
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, Borgess Medical Center, Kalamazoo, MI 49048, USA.
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Kamath
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, Borgess Medical Center, Kalamazoo, MI 49048, USA.
authors.forename: Jagadeesh K
authors.initials: JK
authors.lastname: Kalavakunta
references.citation: Int J Cardiol. 2014 Apr 15;173(1):33-9
references.pmid: 24594256
references.citation: Vasc Surg. 1973 May-Jun;7(3):155-64
references.pmid: 4716633
references.citation: Proc R Soc Med. 1975 Nov;68(11):745-6
references.pmid: 1197308
references.citation: Ann Thorac Surg. 2007 Jul;84(1):156-60
references.pmid: 17588403
references.citation: Eur J Cardiothorac Surg. 2013 Jun;43(6):1188-93
references.pmid: 23293320
references.citation: Scand J Thorac Cardiovasc Surg. 1983;17 (3):249-53
references.pmid: 6359392
references.citation: Catheter Cardiovasc Interv. 2014 Dec 1;84(7):1184-9
references.pmid: 24347248
references.citation: Scand Cardiovasc J. 2011 Dec;45(6):374-8
references.pmid: 21815867
references.citation: Ann Thorac Surg. 1998 Nov;66(5):1604-10
references.pmid: 9875759
references.citation: Chin Med J (Engl). 2014;127(23):4066-70
references.pmid: 25430450
references.citation: J Thorac Cardiovasc Surg. 2005 Apr;129(4):951-2
references.pmid: 15821675
references.citation: J Thorac Cardiovasc Surg. 2013 Oct;146(4):874-8
references.pmid: 23312973
references.citation: Eur J Cardiothorac Surg. 2013 Mar;43(3):591-6
references.pmid: 22864792
references.citation: Ann Thorac Surg. 2011 Feb;91(2):542-8
references.pmid: 21256310