Rupture of Aneurysm of the Right Sinus of Valsalva Into the Right Ventricular Outflow Tract
2002; Lippincott Williams & Wilkins; Volume: 105; Issue: 1 Linguagem: Inglês
10.1161/hc0102.100422
ISSN1524-4539
AutoresSeamus Cullen, Michael Vogel, John Deanfield, Andrew N. Redington,
Tópico(s)Cardiac tumors and thrombi
ResumoHomeCirculationVol. 105, No. 1Rupture of Aneurysm of the Right Sinus of Valsalva Into the Right Ventricular Outflow Tract Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBRupture of Aneurysm of the Right Sinus of Valsalva Into the Right Ventricular Outflow TractTreatment With Amplatzer Atrial Septal Occluder Seamus Cullen, MB, BCh, BaO, FRCPI, Michael Vogel, MD, PhD, John E. Deanfield, MB, BChir, MRCP and Andrew N. Redington, MD, FRCP Seamus CullenSeamus Cullen From the Grown up Congenital Heart Department, Middlesex Hospital (S.C., M.V., J.E.D.) and Cardiac Unit, Great Ormond Street Hospital for Children, NHS Trust, (A.N.R.), London, UK. , Michael VogelMichael Vogel From the Grown up Congenital Heart Department, Middlesex Hospital (S.C., M.V., J.E.D.) and Cardiac Unit, Great Ormond Street Hospital for Children, NHS Trust, (A.N.R.), London, UK. , John E. DeanfieldJohn E. Deanfield From the Grown up Congenital Heart Department, Middlesex Hospital (S.C., M.V., J.E.D.) and Cardiac Unit, Great Ormond Street Hospital for Children, NHS Trust, (A.N.R.), London, UK. and Andrew N. RedingtonAndrew N. Redington From the Grown up Congenital Heart Department, Middlesex Hospital (S.C., M.V., J.E.D.) and Cardiac Unit, Great Ormond Street Hospital for Children, NHS Trust, (A.N.R.), London, UK. Originally published1 Jan 2002https://doi.org/10.1161/hc0102.100422Circulation. 2002;105:e1–e2A 40-year-old asymptomatic woman who had been followed elsewhere for a presumed small ventricular septal defect and mild aortic regurgitation presented to our unit with a continuous heart murmur. Transthoracic ECG confirmed the diagnosis of a ruptured aneurysm of the right sinus of Valsalva into the right ventricular (RV) outflow tract. Under general anesthesia, a transesophageal echocardiogram (TEE) was performed (Figure 1), which demonstrated a rupture of the right sinus of Valsalva into the RV outflow tract. After angiography (Figure 2), a 6-mm Amplatzer septal occluder was placed through the RV outflow tract. TEE and angiog-raphy (Figure 3) confirmed a good position of the device and no residual shunting, as well as no obstruction to the RV outflow tract or the coronary arteries. The patient was discharged the following day. Transcatheter closure is an effective treatment for a ruptured aneurysm of a sinus of Valsalva in selected cases. Download figureDownload PowerPointFigure 1. TEE of the left and right ventricular outflow tracts. The B-mode image (left) demonstrated the aneurysm and its rupture into the RV outflow tract. Color Doppler (right) showed the turbulent flow through the rupture and trivial aortic valve regurgitation.Download figureDownload PowerPointFigure 2. Angiography of the aortic root confirmed a ruptured aneurysm of the sinus of Valsava (arrow) into the RV outflow tract (left). Aortic root angiography after placement of the Amplatzer device (right) demonstrated correct position of the device (arrows). Ao indicates aorta; RVO, RV outflow tract.Download figureDownload PowerPointFigure 3. TEE confirmed that the device had occluded the communication between the aortic root (Ao) and the RV outflow tract (RVO). LV indicates left ventricle.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University Of Texas Medical School and Baylor College of Medicine.Circulation encourages its readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MCI-267, Houston, TX 77030.Research at the Institute of Child Health and Great Ormond Street Hospital for Children National Health Service (NHS) Trust benefits from research and development funding received from the NHS Executive.FootnotesCorrespondence to Andrew Redington, Hospital for Sick Children, Toronto, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Ahmed K, Munawar M, Chakraborty R, Hartono B and Yusri A (2014) Device sizing for transcatheter closure of ruptured sinus of Valsalva as per echocardiography color Doppler turbulent flow jet diameter, Cardiovascular Intervention and Therapeutics, 10.1007/s12928-014-0257-5, 30:1, (92-96), Online publication date: 1-Jan-2015. (2015) Patient Study 45 Patient Studies in Valvular, Congenital, and Rarer Forms of Cardiovascular Disease, 10.1002/9781118469767.ch45, (302-309) Kuriakose E, Bhatla P and McElhinney D (2015) Comparison of Reported Outcomes With Percutaneous Versus Surgical Closure of Ruptured Sinus of Valsalva Aneurysm, The American Journal of Cardiology, 10.1016/j.amjcard.2014.11.013, 115:3, (392-398), Online publication date: 1-Feb-2015. 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Mahimarangariah J, Kikkeri H S, Rai K M and Nanjappa M (2013) Combined transcatheter device closure of ruptured sinus of valsalva and a post-surgical residual ventricular septal defect, Catheterization and Cardiovascular Interventions, 10.1002/ccd.24889, 82:6, (E803-E808), Online publication date: 15-Nov-2013. Srivastava A and Radha A (2011) Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm Into the Left Ventricle: A Retrograde Approach, Pediatric Cardiology, 10.1007/s00246-011-0127-1, 33:2, (347-350), Online publication date: 1-Feb-2012. Hoey E, Gulati G, Singh S, Watkin R, Nazir S, Ganeshan A, Rafique A and Sivananthan M (2012) The role of multi-modality imaging for sinus of Valsalva aneurysms, The International Journal of Cardiovascular Imaging, 10.1007/s10554-011-0001-5, 28:7, (1725-1738), Online publication date: 1-Oct-2012. 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Szkutnik M, Kusa J, Glowacki J, Fiszer R and Bialkowski J (2009) Transcatheter Closure of Ruptured Sinus Valsalva Aneurysms With Amplatzer Occluder, Revista Española de Cardiología (English Edition), 10.1016/S1885-5857(09)73359-6, 62:11, (1317-1321), Online publication date: 1-Nov-2009. Santoro G, Pacileo G, Bigazzi M, Russo M, Caianiello G and Calabrò R (2007) Transcatheter closure of ruptured sinus of Valsalva aneurysm causing Fontan circulation failure, Journal of Cardiovascular Medicine, 10.2459/01.JCM.0000269713.10565.91, 8:6, (470-472), Online publication date: 1-Jun-2007. Schaeffler R, Sarikouch S and Peuster M (2007) Transcatheter closure of a ruptured sinus of Valsalva aneurysm (RSVA) after aortic valve replacement using the Amplatzer muscular VSD Occluder, Clinical Research in Cardiology, 10.1007/s00392-007-0573-1, 96:12, (904-906), Online publication date: 1-Dec-2007. 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