Ruptured aneurysm of the right coronary sinus of Valsalva in a child with Down syndrome

Sinus of Valsalva Aneurysm and Infective Endocarditis Involving a Bicuspid Aortic Valve in an Infant With Trisomy 21

A 19-month-old girl with trisomy 21 and a congenitally bicuspid aortic valve died following a short febrile illness. Autopsy disclosed pericarditis, epimyocardial abscess, infective endocarditis, and a sinus of Valsalva aneurysm. Microscopy demonstrated continuity between the aortic wall and valve leaflet, consistent with an acquired aneurysm. Abnormal hemodynamics associated with the valve malformation likely facilitated endocarditis.

Sinus of Valsalva Aneurysm in a Patient With Mosaic Trisomy 13: Case Report and Brief Review of the Literature

This report describes a unique case involving an obese 16-year-old boy with a mosaic form of trisomy 13 and no previous cardiac history who presented with a new murmur, hypertension, pleural effusions, and congestive heart failure in the context of sore throat and fever. Evaluation revealed a diagnosis of ruptured noncoronary sinus of Valsalva (SOV) aneurysm. The diagnosis and surgical management of a ruptured noncoronary SOV aneurysm in a pediatric patient are briefly outlined. An SOV aneurysm is an anatomic dilation of one of the sinuses of the aortic root. Aneurysmal dilation occurs more commonly in the right aortic sinus (70%-80%), compared to the noncoronary sinus (23%-25%), and more rarely the left coronary sinus (5%). Rupture of these aneurysms has been reported to be both spontaneous and secondary to physical exertion, hypertension, or trauma. Signs of rupture include a continuous murmur, patients may present with chest pain or with symptoms of acute congestive heart failure. Diagnosis, in this case, was made by transthoracic echocardiography with careful interpretation of color Doppler images.

Assessment of the structure and function of the aorta by echocardiography

Echocardiography is the primary modality for imaging the aorta for the diagnosis and serial evaluation of pathological conditions. In this article, we review the methodology for optimal echocardiographic imaging of the various segments of the aorta and discuss abnormalities of the aorta including stenosis, dilation including aortopathy and sinus of Valsalva aneurysms, and fistulous communications involving the ascending aorta including aortoventricular tunnel and ruptured sinus of Valsalva aneurysm. We review novel echocardiographic measurements of aortic functional properties of the aorta such as elasticity and stiffness, and review the literature on the potential additive value of such measurements for structural assessment alone. Finally, we discuss the limitations of echocardiography in the precise and optimal imaging of the aorta.

Giant unruptured sinus of Valsalva aneurysm with complete heart block

In this rare case report of giant unruptured sinus of Valsalva aneurysm (SOVA), a 17-year-old male presented with sudden onset syncope due to complete heart block (CHB). An emergency evaluation was done with the help of transthoracic echocardiography, transesophageal echocardiography, and cardiac catheterization with support of temporary pacemaker. The obvious distorting effects of a giant SOVA dissecting into interventricular septum were CHB, significant regurgitation of tricuspid and mitral valve, mild regurgitation aortic valve and biventricular dysfunction. The case was treated by repair of SOVA and posterior mitral ring annuloplasty. CHB improved to sinus rhythm on 11th day after surgery. On follow-up, tricuspid valve regurgitation improved to mild regurgitation and he continued to have mild aortic regurgitation. .