Korean Circ J.  2012 Dec;42(12):869-871. 10.4070/kcj.2012.42.12.869.

Valsalva Aneurysm Filled with Thrombi Mimicking a Cardiac Tumor

• Lee Y
• Mori N
• Nakamura D
• Yoshimura
• Taniike M
• Makino N
• Kato H
• Egami Y
• Shutta R
• Tanouchi J
• Yamada Y
• Nishino M

• KMID: 1491107
• DOI: http://doi.org/10.4070/kcj.2012.42.12.869

Abstract

A Valsalva aneurysm filled with thrombi can be difficult to diagnose, because it mimics a cardiac tumor. Both cardiac magnetic resonance imaging (MRI) and transesophageal echocardiogram (TEE) were performed on a patient who showed a low-echoic mass located between the atrial septum and the non-coronary sinus. Based on MRI findings allowing tissue characterization and the accurate location of the mass and the TEE findings of an irregular surface of the mass and a partial defect in the edge of the non-coronary sinus, we diagnosed the mass as a thrombosed Valsalva aneurysm that had perforated the inter-atrial septum. The operative findings coincided with the preoperative diagnosis. Both MRI and TEE are useful for diagnosing this condition.

Keyword

Sinus of Valsalva; Cardiac tumor; 2D echocardiography; Magnetic resonance imaging

MeSH Terms

Aneurysm
Atrial Septum
Echocardiography
Heart Neoplasms
Humans
Magnetic Resonance Imaging
Sinus of Valsalva

Figure

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  Fig. 1 The transthoracic echocardiography demonstrates a low echoic mass (26×30 mm) (dotted arrow) located between the atrial septum and the noncoronary sinus. LA: left atrium, RA: right atrium, RV: right ventricle.

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  Fig. 2 The findings from magnetic resonance imaging (MRI). A: T2-weighted fast spin-echo image. The arrow shows the mass, which presented with high signal intensity mostly, mixed with focal low signal intensity on T2-weighted fast spin-echo image. B: T1-weighted fast spin-echo image. The arrow shows the mass, which presented with dark signal intensity. C: a cine MRI reveals that the mass is connected to the non-coronary sinus and is not located in the right atrium (RA). LA: left atrium.

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  Fig. 3 A transesophageal echocardiography (TEE) which shows a dilated non-coronary sinus filled with a low echoic mass suspected to be thrombi (dotted arrow), because the mass surface in the non-coronary sinus is irregular. The edge of the non-coronary sinus is defected, which might have indicated a perforated lumen. LA: left atrium, RA: right atrium.

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  Fig. 4 The operative findings reveal that the non-coronary sinus is defected and filled with thrombi (arrow).

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