Al-Sabeq B, De S, Davey R. A case of ruptured sinus of Valsalva aneurysm and reversible flow-induced pulmonary hypertension.
Pulm Circ 2018;
8:2045894018760656. [PMID:
29480096 PMCID:
PMC5888825 DOI:
10.1177/2045894018760656]
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Abstract
Pulmonary hypertension (PH) in adults with congenital heart disease (CHD) and significant systemic-to-pulmonary shunting is a significant cause of morbidity and mortality. Its pathophysiology is incompletely understood, but involves a flow-induced pulmonary arteriopathy characterized by endothelial cell dysfunction and vascular remodeling that alters pulmonary arterial vasoreactivity. There is a paucity of literature linking PH with left-to-right shunting due to ruptured sinus of Valsalva aneurysms (SOVA). We present a unique case of reversible, flow-associated PH due to a ruptured congenital right SOVA fistulizing into the right atrium (RA), with emphasis on non-invasive and invasive assessment of pulmonary hemodynamics before and after surgical intervention.
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