Rupture of Sinus of Valsalva Aneurysm With Aorto-Biventricular Fistulas and Right-Ventricular Outflow Tract Obstruction: A Unique Association
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Sinus of Valsalva aneurysms are a rare entity. Rupture of such aneurysms is a major cause of aortocardiac fistulas usually occurring between the right sinus of Valsalva and right cardiac chambers. We report an exceptional case of a ruptured congenital sinus of Valsalva aneurysm with fistulas involving both the right- and left-ventricular outflow tracts and causing RVOT obstruction. We also demonstrate the utility of computed tomography angiography and transesophageal echocardiography in diagnosing these fistulas.
KeywordsRupture sinus of Valsalva aneurysm Aorto-ventricular fistula Right-ventricular outflow tract obstruction
TEE demonstrating the fistula between the aortic root and the right ventricle
TEE with color flow Doppler demonstrating the aorto-biventricular fistulas between the right coronary sinus and both ventricular outflow tracts