Rupture of a Surgically Repaired Sinus of Valsalva Aneurysm

Journal of Clinical and Basic Cardiology 2002; 5 (2): 199-200

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Keywords: aortoatriale Fistel,  aortokardiale Fistel,  Herzchirurgie,  kongenitale Herzinsuffizienz,  kongestive Herzinsuffizienz,  Ruptur,  Sinus-Valsalvae-Aneurysma,  aortic disease,  aortoatrial fistula,  aortocameral fistula,  aortocardiac fistula,  cardiac surgery,  congenital heart disease,  congestive heart failure,  rupture,  sinus of valsalva aneurysm

Congenital aneurysms of aortic sinuses of Valsalva are uncommon anomalies caused by congenital defects in a region between aortic media and aortic fibrous ring. They are thin walled, tubular outpouchings with an entirely intracardiac course, and have a tendency to rupture into cardiac chambers, mostly right-sided, resulting in formation of an aortocardiac fistula. Surgical repair is the treatment of choice. Although the surgical repair usually is successful with good short- and long-term prognosis, rupture of a repaired sinus of Valsalva aneurysm is still possible. Here reported is a 50-year-old patient who underwent surgical repair of a right sinus of Valsalva aneurysm, and one month later presented with complaints of shortness of breath, orthopnoea, paroxysmal nocturnal dyspnoea, and chest pain. He underwent transoesophageal echocardiography, aortography, and cardiac catheterization. These investigations demonstrated rupture of the previously repaired right sinus of Valsalva resulting in formation of a fistula between aorta and right atrium with a left to right shunt. He subsequently underwent a successful repair of the ruptured sinus of Valsalva and closure of aortoatrial fistula.