Rapid growth of thrombus formation in the unruptured sinus of Valsalva aneurysm following coronary angiography

Surgical management for unruptured sinus of Valsalva aneurysms: a narrative review of the literature

Unruptured sinus of Valsalva aneurysms (SVAs) are rare cardiac lesions that arise due to congenital or acquired etiologies. They could be asymptomatic or cause various clinical manifestations as a consequence of their mass effect on the coronary arteries, heart valves, and other adjacent structures. While the factors predicting SVA rupture are not fully understood, ruptured SVAs carry a high complication and mortality rate, highlighting the need for early recognition and management of unruptured SVAs. Imaging modalities such as echocardiography, computed tomography (CT), angiography, and magnetic resonance imaging (MRI) are essential in identifying and characterizing the aneurysm as well as associated cardiac anomalies. However, there are no specific guidelines for the diagnosis and management of SVAs. Herein, we performed a contemporary systematic review to examine the presentation, diagnostic tests and findings, as well as outcomes for surgical intervention of unruptured SVAs. We demonstrate that surgical repair remains the preferred method of treatment in order to prevent complications such as rupture or thrombus formation. Surgery should be prompted in patients with symptomatic, large, or rapidly expanding unruptured SVAs, as well as those unruptured SVAs that contain intraluminal thrombi, have a mass effect on surrounding structures, or are recurrent. Surgical outcomes are generally good with favourable prognosis and minimal recurrence.

Ruptured Aneurysm of the Sinus of Valsalva Causing Pulmonary Embolism: A Rare Association

Aneurysms of the sinus of Valsalva are rare. Unruptured sinus of Valsalva aneurysm is usually asymptomatic and rarely presents as right ventricular outflow obstruction, myocardial infarction as a result of coronary artery compression, conduction disturbances, or endocarditis. They have only been reported as the presumed source of embolism in six cases. We report a patient with right sinus of Valsalva rupture to the right atrium and embolization of aneurysm contents to the pulmonary vasculature.

Unruptured right sinus of Valsalva aneurysm in a Maltese dog: a case report

A rare case of an unruptured sinus of Valsalva aneurysm (SVA) in a 2-month-old male Maltese terrier weighing 1.0 kg with a heart murmur is presented. A right SVA and a ventricular septal defect (VSD) were diagnosed by echocardiography and cardiac catheterization. The dog died due to a worsening of his condition. The necropsy revealed the sinus of Valsalva to have a diameter of 7 mm and a VSD hole was on the opposite surface. This report is the first to describe an unruptured SVA in the right coronary cusp of a small dog.

Ruptured Sinus of Valsalva Aneurysm and Gerbode Defects: Patient and Procedural Selection: the Key to Optimising Outcomes

PURPOSE OF REVIEW

In this review, we reflect on the historical background, clinical features and imaging techniques used to assess Gerbode defects and sinus of Valsalva aneurysms. We aim to review the evolution of treatment strategies and the progression towards less invasive management for these conditions.

RECENT FINDINGS

While transthoracic echocardiography is often diagnostic, transesophageal echocardiography (2D and 3D) has improved our understanding of these defects and allowed us to more accurately define their anatomy. Cardiac MRI provides improved assessment of the physiological impact of defects by quantifying shunt volume. Transcatheter techniques are currently vying with surgery as the mainstay of treatment. New insights are being discovered regarding diagnostic modalities and treatment pathways. Defining criteria for patient selection for catheter or surgical therapy is essential when deciding on the optimum intervention for the individual patient.