Rupture of sinus of Valsalva aneurysm into the left ventricle after dissecting through the interventricular septum mimicking aortic regurgitation

Aortic dissection extending into the interventricular septum following redo aortic valve replacement surgery in a patient with Takayasu's arteritis: a rare case report

Background

Takayasu's arteritis is an infrequent manifestation of vasculitis affecting the aorta and its primary branches with numerous symptoms. This report details a rare case wherein a patient developed interventricular septal dissection following aortic valve replacement.

Case summary

A middle-aged woman diagnosed with Takayasu's arteritis previously underwent aortic valve replacement with a mechanical valve owing to severe aortic regurgitation. Subsequently, she received a redo aortic valve replacement following an episode of prosthetic valve infective endocarditis with paravalvular leak. Heart failure symptoms emerged during follow-up, revealing aortic root dissection extending into the interventricular septum, causing significant prosthetic valve movement. A Trido Bentall operation and interventricular septum repair were performed, and the patient recovered smoothly.

Discussion

Interventricular dissection, although uncommon, may be due to factors such as infection, myocardial infarction, congenital anomalies, trauma, or post-surgical shear stress. Timely diagnosis is imperative to prevent life-threatening complications; surgery remains the primary treatment. The present case report describes a rare presentation that was successfully managed through a Bentall operation and underscores the necessity of prompt intervention in treating this condition.

Aneurysms of Aortic Sinus of Valsalva Dissecting through the Interventricular Septum With Rupture into the Left Ventricle: Case Series and Literature Review

Aneurysm of Aortic sinus of Valsalva (ASOV) dissecting into the interventricular septum (IVS) and rupturing into the left ventricle (LV) is a rare clinical diagnosis. Systemic inflammatory diseases like tuberculosis can aggravate this condition. We describe three cases of ASOV dissecting into the IVS and rupturing into the LV. All three patients underwent surgical intervention; two had a successful outcome. A literature review was conducted and19 previously reported cases were studied. The extent and direction of septal dissection determined the associated cardiac valvular and rhythm problems. Patch closure of the mouth of the aneurysm is the surgical method of choice. In the presence of multiple sinus tracts or if there is recurrence after surgical closure, aortic sinus or root replacement techniques have better outcomes.

Rupture of sinus of Valsalva aneurysm: a case report in a child

Background

Sinus of Valsalva aneurysm (SVA) is a rare congenital disease that can cause severe clinical presentations when the aneurysm ruptures. Here, we report a rare case of a noncoronary sinus of Valsalva aneurysm with rupture into the right atrium.

Case presentation

A 14-year-old Chinese female patient presented viral myocarditis with acute heart failure at the local hospital, and she was finally diagnosed with a noncoronary sinus Valsalva aneurysm with rupture into the right atrium by digital subtraction angiography with cardiac catheterization angiography and echocardiography at our hospital (Children’s Hospital of Chongqing Medical University). Percutaneous closure intervention was performed shortly after her diagnosis, and the patient showed good functional recovery.

Conclusions

We report a case of ruptured sinus of Valsalva aneurysm successfully treated by percutaneous closure, which is an excellent alternative treatment.

Delayed aortic regurgitation due to traumatic pseudoaneurysm of the sinus of Valsalva

Case

Pseudoaneurysm of the sinus of Valsalva (PSV) caused by trauma is rare. Surgical intervention is the standard treatment approach for traumatic PSV, as it has a high risk of rupture and is potentially fatal.We hereby report a 59‐year‐old man with traumatic PSV due to a traffic accident. Imaging studies revealed traumatic PSV. However, he refused surgery due to the lack of symptoms and was discharged on day 9. Two years later, he visited our hospital with cardiac failure due to severe aortic valve regurgitation (AR) induced by PSV.

Outcome

A Bentall operation was carried out and the patient was discharged without any complications.

Conclusions

This case illustrates progression to aortic valve regurgitation as a complication of traumatic PSV and stresses the point that surgical intervention should be considered even in asymptomatic cases of traumatic PSV.

First computed tomography angiography image (Fig. 1.) and three‐dimensional reconstruction of multidetector computed tomography (Fig. 2.) of a 59‐year‐old man with traumatic pseudoaneurysm of the sinus of Valsalva due to a traffic accident revealed expansion of the sinus of Valsalva (diameter of 37.5 ms).

A case report of pseudoaneurysm of left sinus of Valsalva invaded into the left ventricle with severe aortic regurgitation

Background

The pseudoaneurysms of sinus of Valsalva is an uncommon and serious complication of an infection, trauma, or after cardiac surgery or procedure. Pseudoaneurysms of sinus of Valsalva from left is rare. We describe a case of pseudoaneurysm of the left coronary sinus of Valsalva invaded into the left ventricle (LV) diagnosed by transthoracic echocardiography (TTE), transesophageal ecoccardiography (TEE), and multiple detector computed tomography (MDCT).

Case presentation

A 44-year-old male patient had New York Heart Association (NYHA) class II / III dyspnea during 4 months. He underwent surgery including aortic valve replacement using mechanical prosthesis, and he was discharged well without significant complications on follow – up TTE and chest computed tomography (CT) post-operative 7 days.

Conclusions

We report this rare case in which a ruptured pseudoaneurysm of sinus of Valsalva into LV with severe AR due to perforation of LCC was successfully-treated.