Skip to main content
Log in

Ruptured sinus of Valsalva aneurysm in two patients with subarterial ventricular septal defect

  • CASE REPORT
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Summary

Rupture of a sinus of Valsalva aneurysm (SVA) is a rare, but life–threatening, event and requires immediate recognition and intervention. We present two previously healthy and physically active patients who were 12 and 33 years of age when rupture of a right coronary SVA into the right ventricle occurred. A subarterial ventricular septal defect (VSD) was detectable in both patients. Cardiac surgery involved VSD closure as well as reconstruction of the aortic valve. Considering complications of subarterial VSD, such as aortic cusp prolapse, aortic insufficiency or SVA, we suggest close follow–up and surgical closure of the VSD in case of any aortic valve deformity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Au WK, Chiu SW, Mok CK, Lee WT, Cheung D, He GW (1998) Repair of ruptured sinus of valsalva aneurysm: determinants of long–term survival. Ann Thorac Surg 66:1604–1610

    Article  CAS  PubMed  Google Scholar 

  2. Barragry TP, Ring WS, Moller JH, Lillehei CW (1988) 15– to 30–year follow– up of patients undergoing repair of ruptured congenital aneurysms of the sinus of Valsalva. Ann Thorac Surg 46:515–519

    Article  CAS  PubMed  Google Scholar 

  3. Choudhary SK, Bhan A, Sharma R, Airan B, Kumar AS, Venugopal P (1997) Sinus of Valsalva aneurysms: 20 years’ experience. J Card Surg 12:300–308

    CAS  PubMed  Google Scholar 

  4. Goldberg N, Krasnow N (1990) Sinus of Valsalva aneurysms. Clin Cardiol 13:831–836

    Article  CAS  PubMed  Google Scholar 

  5. Griffin ML, Sullivan ID, Anderson RH, Macartney FJ (1988) Doubly committed subarterial ventricular septal defect: new morphological criteria with echocardiographic and angiocardiographic correlation. Br Heart J 59:474–479

    CAS  PubMed  Google Scholar 

  6. Kirali K, Guler M, Daglar B, Yakut N, Mansuroglu D, Balkanay M, Berki T, Gurbuz A, Isik O, Yakut C (1999) Surgical repair in ruptured congenital sinus of Valsalva aneurysms: a 13– year experience. J Heart Valve Dis 8:424–429

    CAS  PubMed  Google Scholar 

  7. Lin CY, Hong GJ, Lee KC, Tsai YT, Tsai CS (2004) Ruptured congenital sinus of valsalva aneurysms. J Card Surg 19:99–102

    Article  PubMed  Google Scholar 

  8. Lun K, Li H, Leung MP, Chau AK, Yung T, Chiu CS, Cheung Y (2001) Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation. Am J Cardiol 87:1266–1270

    Article  CAS  PubMed  Google Scholar 

  9. Momma K, Toyama K, Takao A, Ando M, Nakazawa M, Hirosawa K, Imai Y (1984) Natural history of subarterial infundibular ventricular septal defect. Am Heart J 108:1312–1317

    Article  CAS  PubMed  Google Scholar 

  10. Murray EG, Minami K, Kortke H, Seggewiss H, Korfer R (1993) Traumatic sinus of Valsalva fistula and aortic valve rupture. Ann Thorac Surg 55:760–761

    Article  CAS  PubMed  Google Scholar 

  11. Oztunc F, Akalin F, Polat B, Bilal MS (1999) Echocardiographic diagnosis of sinus Valsalva aneurysm rupture in two pediatric patients. Turk J Pediatr 41:127–132

    CAS  PubMed  Google Scholar 

  12. Rey C, Leroy O, Francart C, Marchand X, Ducloux G, Dupuis C (1986) Aneurysm of the sinus of Valsalva in children and young adults. Apropos of 9 cases. Arch Mal Coeur Vaiss 79:668–675

    CAS  PubMed  Google Scholar 

  13. Rhodes LA, Keane JF, Keane JP, Fellows KE, Jonas RA, Castaneda AR, Nadas AS (1990) Long follow–up (to 43 years) of ventricular septal defect with audible aortic regurgitation. Am J Cardiol 66:340–345

    Article  CAS  PubMed  Google Scholar 

  14. Ring WS (2000) Congenital heart surgery nomenclature and database project: aortic aneurysm, sinus of Valsalva aneurysm, and aortic dissection. Ann Thorac Surg 69:S147–S163

    Article  CAS  PubMed  Google Scholar 

  15. Shah RP, Ding ZP, Ng AS, Quek SS (2001) A ten–year review of ruptured sinus of valsalva: clinico–pathological and echo–Doppler features. Singapore Med J 42:473–476

    CAS  PubMed  Google Scholar 

  16. Sim EK, Grignani RT, Wong ML, Quek SC, Wong JC, Yip WC, Lee CN (1999) Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg 67:736–738

    Article  CAS  PubMed  Google Scholar 

  17. Takach TJ, Reul GJ, Duncan JM, Cooley DA, Livesay JJ, Ott DA, Frazier OH (1999) Sinus of Valsalva aneurysm or fistula: management and outcome. Ann Thorac Surg 68:1573– 1577

    Article  CAS  PubMed  Google Scholar 

  18. Therrien J, Dore A, Gersony W, Iserin L, Liberthson R, Meijboom F, Colman JM, Oechslin E, Taylor D, Perloff J, Somerville J, Webb GD (2001) CCS Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I. Can J Cardiol 17:940– 959

    CAS  PubMed  Google Scholar 

  19. Tohyama K, Satomi G, Momma K (1997) Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect. Am J Cardiol 79:1285–1289

    CAS  PubMed  Google Scholar 

  20. Van Praagh R, McNamara JJ (1968) Anatomic types of ventricular septal defect with aortic insufficiency. Diagnostic and surgical considerations. Am Heart J 75:604–619

    Article  CAS  PubMed  Google Scholar 

  21. van Son JA, Danielson GK, Schaff HV, Orszulak TA, Edwards WD, Seward JB (1994) Long–term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation 90:II20–II29

    CAS  PubMed  Google Scholar 

  22. van Son JA, Sim EK, Starr A (1995) Morphometric features of ruptured congenital sinus of Valsalva aneurysm: implication for surgical treatment. J Cardiovasc Surg (Torino) 36:433–436

    CAS  Google Scholar 

  23. Vural KM, Sener E, Tasdemir O, Bayazit K (2001) Approach to sinus of Valsalva aneurysms: a review of 53 cases. Eur J Cardiothorac Surg 20:71– 76

    Article  CAS  PubMed  Google Scholar 

  24. Wiemer J, Winkelmann BR, Beyersdorf F, Sarai K, Reifart N, Hofmann M, Klepzig H (1996) Multiplicity of clinical symptoms and manifestations of unruptured aneurysms of the sinus of Valsalva–3 case reports. Z Kardiol 85:221–225

    CAS  PubMed  Google Scholar 

  25. Yacoub MH, Khan H, Stavri G, Shinebourne E, Radley–Smith R (1997) Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of Valsalva, and ventricular septal defect. J Thorac Cardiovasc Surg 113:253–260; discussion 261

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ulrike Doll.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doll, U., Herberg, U., Tiemann, K. et al. Ruptured sinus of Valsalva aneurysm in two patients with subarterial ventricular septal defect. Clin Res Cardiol 95, 127–131 (2006). https://doi.org/10.1007/s00392-006-0333-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-006-0333-7

Key words

Navigation