Unruptured Sinus of Valsalva Aneurysm with Right Ventricular Outflow Tract Obstruction and Supracristal Ventricular Septal Defect: A Rare Case

• Published in: Texas Heart Institute journal 2015-10, Vol.42 (5), p.462-464
• Main Authors: Sridhar, Ganiga Srinivasaiah, Sadiq, Muhammad Athar, Ahmad, Wan Azman Wan, Supuramaniam, Chitra, Watson, Timothy, Abidin, Imran Zainal, Chee, Kok Han
• Format: Article
• Language: English
• Subjects: Aortic Aneurysm - complications; Aortic Aneurysm - diagnosis; Aortic Aneurysm - physiopathology; Aortic Aneurysm - surgery; Aortic Valve - physiopathology; Aortic Valve - surgery; Case Reports; Dyspnea - etiology; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Female; Heart Septal Defects, Ventricular - complications; Heart Septal Defects, Ventricular - diagnosis; Heart Septal Defects, Ventricular - physiopathology; Heart Septal Defects, Ventricular - surgery; Heart Valve Prosthesis Implantation; Humans; Hypertrophy, Right Ventricular - etiology; Middle Aged; Sinus of Valsalva - diagnostic imaging; Sinus of Valsalva - physiopathology; Sinus of Valsalva - surgery; Treatment Outcome; Ventricular Outflow Obstruction - diagnosis; Ventricular Outflow Obstruction - etiology; Ventricular Outflow Obstruction - physiopathology; Ventricular Outflow Obstruction - surgery
• ISSN: 0730-2347; 1526-6702
• DOI: 10.14503/THIJ-14-4483

Unruptured right sinus of Valsalva aneurysm that causes severe obstruction of the right ventricular outflow tract is extremely rare. We describe the case of a 47-year-old woman who presented with exertional dyspnea. Upon investigation, we discovered an unruptured right sinus of Valsalva aneurysm with associated right ventricular outflow tract obstruction and a supracristal ventricular septal defect. To our knowledge, only 2 such cases have previously been reported in the medical literature. Although treatment of unruptured sinus of Valsalva aneurysm remains debatable, surgery should be considered for extremely large aneurysms or for progressive enlargement of the aneurysm on serial evaluation. Surgery was undertaken in our patient because there was clear evidence of right ventricular outflow tract obstruction, right-sided heart dilation, and associated exertional dyspnea.