Silent rupture of sinus of Valsalva aneurysm: a refutation of the Okham's razor principle

2011 ◽  
Vol 21 (6) ◽  
pp. 713-715 ◽  
Author(s):  
Joseph Dayan ◽  
Suvro Sett ◽  
Usha Krishnan
Keyword(s):  
Infective Endocarditis ◽  
Cardiac Failure ◽  
Adverse Outcomes ◽  
Unusual Presentation ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Unruptured Aneurysms ◽  
Congenital Lesion ◽  
History Of ◽  
Physical Examinations

AbstractAneurysm of the sinus of Valsalva is an uncommon congenital lesion rarely reported in children. Unruptured aneurysms commonly go undiagnosed until a rupture has occurred. Usually, ruptured sinus of Valsalva presents with cardiac failure. There may be a history of trauma or infective endocarditis preceding the rupture. Asymptomatic paediatric presentation of ruptured sinus of Valsalva is rare. We discuss the cases of two children who presented with a murmur and were diagnosed with ruptured sinus of Valsalva. This unusual presentation in children highlights the importance of careful routine physical examinations and the evaluation of new murmurs. The Okham's razor principle states that “when you hear hoofbeats – think horses not zebras”. Sometimes, it is important to think beyond the usual in medicine, to avoid missing lesions that, if left untreated, could lead to adverse outcomes.

Rupture of sinus of Valsalva aneurysm: case report and review of contemporary literature

Perfusion ◽  
2020 ◽  
pp. 026765912096691
Author(s):  
Jean-Luc Duval ◽  
Richard AE Ramsingh ◽  
Natasha C Rahaman ◽  
Risshi D Rampersad ◽  
Gianni D Angelini ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Congenital Heart ◽  
Contemporary Literature ◽  
Rare Condition ◽  
Aneurysm Rupture ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
History Of ◽  
High Index Of Suspicion

Sinus of Valsalva aneurysm rupture is a rare condition with a great potential for morbidity and mortality if not promptly diagnosed and managed. We present an unusual non-infected sinus of Valsalva aneurysm rupture in a 47-year-old female. This case report, a likely presentation of a late congenital heart defect, highlights the need for a high index of suspicion in a patient with atypical history of congestive cardiac failure.

scholarly journals Ruptured Sinus of Valsalva Aneurysm Complicating Infective Endocarditis: A Case Report

2016 ◽  
pp. 52-55
Author(s):  
Hasna Fahmima Haque ◽  
Farhana Afroz ◽  
Samira Rahat Afroze ◽  
Gaffar Amin ◽  
AKM Musa ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Cardiac Anomaly ◽  
Transthoracic Echocardiogram ◽  
Exertional Dyspnoea ◽  
Sinus Of Valsalva ◽  
Significant Weight Loss ◽  
Sinus Of Valsalva Aneurysm ◽  
History Of ◽  
Loss Of Appetite ◽  
Cardiothoracic Surgeon

Sinus of Valsalva aneurysm (SVA) is an uncommon cardiac anomaly, usually congenital but may be acquired & rarely ruptures. A 24- year- old male presented with a history of prolonged fever, loss of appetite and significant weight loss along with exertional dyspnoea, palpitation and mild chest pain together with clubbed fingers and toes, mild splenomegaly and a continuous machinery murmur over the left sternal edge with associated thrill. Transthoracic echocardiogram revealed ruptured sinus of Valsalva aneurysm with shunt from aorta to right atrium (RA) and vegetation. He was diagnosed as infective endocarditis with rupture of sinus of Valsalva aneurysm and treated with antibiotics and referred to the cardiothoracic surgeon for repair of ruptured SVA.Birdem Med J 2015; 5(1) Supplement: 52-55

scholarly journals Ruptured aneurysm of right sinus of valsalva - a case report

2016 ◽  
Vol 44 (3) ◽  
pp. 175-177
Author(s):  
Md Nazmul Hasan ◽  
Md Nazmul Hasan ◽  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Md Rasul Amin ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Annulus Fibrosus ◽  
Common Complication ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Aortic Media ◽  
Surgical Options ◽  
Potential Risks ◽  
The Right

The sinus of valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. It may be either acquired or congenital. The right coronary sinus is most frequently affected, with the most common complication being rupture of the sinus. Cardiac failure and sudden auscultation changes suggest the possibility of SVA rupture. Echocardiography is sufficient to diagnose SVA, its complications, repercussions and to determine surgical options. SVA, even if asymptomatic, has potential risks of expansion, rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction which has a low mortality rate in both the short and long-term.Bangladesh Med J. 2015 Sep; 44 (3): 175-177

scholarly journals Aneurisma del seno de Valsalva con doble rotura a la arteria pulmonar y al ventrículo derecho. Reporte de un caso y revisión de la literatura.

2013 ◽  
Vol 6 (2) ◽  
Author(s):  
Jesús Custodio ◽  
Víctor Arauco ◽  
Milvio Ramirez ◽  
Carlos Cerron
Keyword(s):  
Pulmonary Artery ◽  
Cardiac Catheterization ◽  
Clinical Examination ◽  
Cardiac Failure ◽  
Unusual Presentation ◽  
Congestive Cardiac Failure ◽  
Sinus Of Valsalva ◽  
Right Ventricule ◽  
The Right

We report a case of a 21 year old female who presented with congestive cardiac failure. In initial investigations an aneurysm of sinus of Valsalva was found ruptured to the pulmonary artery. It was surgically repaired uneventfully. The patient was discharged home after 10 days. During the follow-up appointments she was found to have reappearing symptoms of congestive cardiac failure. This lead to her readmission and a repeated cardiac catheterization found her to have an aneurysm of sinus of Valsalva reuptured to the right ventricule, which in a second operation was succesfully repaired. We review the bibliography over the last 20 year finding the unusual presentation of the rupture to the pulmonary artery. We point out the importance of a sharp clinical examination and the preference of cardiac catheterization to make the diagnosis.

scholarly journals Infective endocarditis of an aorto-right atrial fistula caused by asymptomatic rupture of a sinus of Valsalva aneurysm: a case report

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Akihiko Ikeda ◽  
Tomomi Nakajima ◽  
Taisuke Konishi ◽  
Kanji Matsuzaki ◽  
Akinori Sugano ◽  
...  
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Right Atrial ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm

scholarly journals Sinus of Valsalva Aneurysm and Infective Endocarditis Involving a Bicuspid Aortic Valve in an Infant With Trisomy 21

2018 ◽  
Vol 8 (3) ◽  
pp. 763-768
Author(s):  
Nicole A. Croom ◽  
Nicole Therrien ◽  
Michael Chambliss ◽  
Philip C. Ursell
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Trisomy 21 ◽  
Aortic Wall ◽  
Febrile Illness ◽  
Valve Leaflet ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm

A 19-month-old girl with trisomy 21 and a congenitally bicuspid aortic valve died following a short febrile illness. Autopsy disclosed pericarditis, epimyocardial abscess, infective endocarditis, and a sinus of Valsalva aneurysm. Microscopy demonstrated continuity between the aortic wall and valve leaflet, consistent with an acquired aneurysm. Abnormal hemodynamics associated with the valve malformation likely facilitated endocarditis.

scholarly journals Sinus of Valsalva aneurysm after blunt chest trauma with complicated perforation by infective endocarditis

2019 ◽  
Vol 3 (2) ◽  
pp. 85-89
Author(s):  
Cheol Won Hyeon ◽  
Sung-Ji Park ◽  
So Ree Kim ◽  
Eun Kyoung Kim ◽  
Sung Mok Kim ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm

scholarly journals Role of Transesophageal Echocardiography in Rupture of Sinus of Valsalva Aneurysm with Associated Infective Endocarditis

2016 ◽  
Vol 4 (2) ◽  
pp. 59-63
Author(s):  
Preeti Sharma ◽  
Goverdhan Dutt Puri ◽  
Harkant Singh ◽  
Bhupesh Kumar ◽  
Ganesh K Munirathinam
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Right Ventricle ◽  
Transesophageal Echocardiography ◽  
Previous History ◽  
Pulmonary Artery Hypertension ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Severe Aortic Regurgitation

ABSTRACT Introduction Sinus of Valsalva aneurysm (SOVA) may have associated infective endocarditis in which case single aneurysm may drain into adjacent chamber of heart via multiple openings. We report a rare case of congenital SOVA with associated infective endocarditis where intraoperative transesophageal echocardiogram (TEE) helped in localizing two separate openings in the SOVA draining into right ventricle and an associated perforation in the larger rightward cusp of bicuspid aortic valve (BAV) causing severe aortic regurgitation. Case report A 28-year-old male presented with grade III to IV dyspnea with previous history of infective endocarditis. Preoperative transthoracic echocardiogram (TTE) showed calcified BAV with severe aortic valve regurgitation and stenosis, severe tricuspid regurgitation, and pulmonary artery hypertension along with ruptured SOVA arising from right coronary sinus and draining into the right ventricle. Intraoperative TEE confirmed the TTE findings and in addition showed the presence of two jets arising from the SOVA draining into right ventricle, a subaortic membrane, and a perforation in the aortic cusp opening into left ventricle. The ruptured SOVA was repaired using single patch technique and aortic valve was replaced. The completeness of the repair was checked using TEE to exclude failure of closure of additional opening if any and the patient was discharged from hospital after 7 days of uneventful postoperative course. Conclusion Sinus of Valsalva aneurysm may have multiple openings draining into adjacent chamber, particularly if associated with infective endocarditis. Intraoperative TEE plays a crucial role in identification of multiple opening, involvement of adjacent structure, and assessment of completeness of repair. How to cite this article Kumar B, Munirathinam GK, Sharma P, Puri GD, Singh H. Role of Transesophageal Echocardiography in Rupture of Sinus of Valsalva Aneurysm with Associated Infective Endocarditis. J Perioper Echocardiogr 2016;4(2):59-63.

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