J Cardiovasc Ultrasound.  2010 Jun;18(2):55-57. 10.4250/jcu.2010.18.2.55.

A Rare Case of Unruptured Sinus of Valsalva Aneurysm Obstructing the Right Ventricular Outflow Tract

• John SH

• KMID: 2135439
• DOI: http://doi.org/10.4250/jcu.2010.18.2.55

Abstract

An unruptured sinus of Valsalva aneurysm is rare and is usually asymptomatic until a symptom associated with its complication develops. Hence, an unruptured sinus of Valsalva aneurysm is not infrequently missed unless echocardiogram is performed with other indications. An unruptured sinus of Valsalva aneurysm rarely protrudes into the right ventricular outflow tract, causing the right ventricular outflow tract obstruction. In this report, I describe a rare case of unruptured sinus of Valsalva aneurysm producing the right ventricular outflow tract obstruction, which was incidentally detected by echocardiography.

Keyword

Sinus of Valsalva; Aneurysm; Ventricular outflow obstruction

MeSH Terms

Aneurysm
Echocardiography
Sinus of Valsalva
Ventricular Outflow Obstruction

Figure

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  Fig. 1 Electrocardiogram shows normal sinus rhythm.

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  Fig. 2 Chest X-ray shows mild cardiomegaly.

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  Fig. 3 Transthoracic echocardiography. Parasternal long axis view (A) shows an aneurysm of the right sinus of Valsalva (arrow). Parasternal short axis views (B and C) show also the aneurysm (arrowheads) and systolic flow acceleration suggesting the RVOT obstruction (arrow). RVOT: right ventricular outflow tract, LV: left ventricle, LA: left atrium, Ao: aorta.

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  Fig. 4 Transesophageal echocardiography. Midesophageal aortic valve long-axis view at 144℃ rotation demonstrating the SVA originating from the right coronary sinus of Valsalva (arrow) (A). Short-axis view at 27℃ rotation demonstrating the SVA protruding into the RVOT (arrowheads) (B). Color Doppler shows flow acceleration due to the RVOT obstruction without shunt flow suggesting SVA rupture (arrow) (C). SVA: sinus of Valsalva aneurysm, RVOT: right ventricular outflow tract, LV: left ventricle, LA: left atrium, Ao: aorta.

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