Large, unruptured, non-coronary sinus of Valsalva aneurysm

Surgical correction of giant extracardiac unruptured aneurysm of the right coronary sinus of Valsalva: case report and review of the literature

We report a quite rare case of giant extracardiac unruptured aneurysm of the right coronary sinus of Valsalva with no clinical findings of Marfan syndrome or Ehlers-Danlos syndrome. A 52-year-old Chinese male was diagnosed having an aneurysm of the right sinus of Valsalva and moderate aortic regurgitation, while Bentall operation was performed successfully. The patient was discharged with no complications. Pathological examination revealed conspicuously medial mucoid degeneration of the aneurismal wall and absence of medial elastic fibers. Immediate results and early follow-up were uneventful.

Valsalva sinus aneurysms: findings at CT and MR imaging

Aneurysms of the Valsalva sinus (aortic sinus) can be congenital or acquired and are rare. They are more common among men than women and among Asians than other ethnic groups. Nonruptured aneurysms may be asymptomatic and incidentally discovered, or they may be symptomatic and manifest acutely with mass effect on adjacent cardiac structures. Ruptured Valsalva sinus aneurysms result in an aortocardiac shunt and may manifest as insidiously progressive congestive heart failure, severe acute chest pain with dyspnea, or, in extreme cases, cardiac arrest. Although both ruptured and nonruptured Valsalva sinus aneurysms may have potentially fatal complications, after treatment the prognosis is excellent. Thus, prompt and accurate diagnosis is critical. Most Valsalva sinus aneurysms are diagnosed on the basis of echocardiography, with or without angiography. However, both electrocardiographically gated computed tomography and magnetic resonance (MR) imaging can provide excellent anatomic depiction, and MR imaging can provide valuable functional information.