Giant unruptured sinus of Valsalva aneurysm with complete heart block

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• 作者：Ramachandra Barik ; DNB ; ^{cardioramachandra@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Lalita Nemani ; DM ; Ramesh Chandra Mishra ; MCH
• 关键词：Sinus of Valsalva aneurysm ; Complete heart block ; Temporary pacemaker ; Biventricular dysfunction ; Mitral ring annuloplasty
• 刊名：Journal of Cardiology Cases
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：13
• 期：1
• 页码：17-20
• 全文大小：1733 K

文摘

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.

<Learning objective: Sinus of Valsalva aneurysm (SOVA) may present with cardiac emergency without rupture. A giant unruptured SOVA competes for space with neighboring intra cardiac structures. The distorting effects are erosion into interventricular septum, complete heart block (CHB), valvular and ventricular dysfunction. Transthoracic and transesophageal echocardiography provide enough information for emergency surgery. Sometimes, evaluation may need cardiac catheterization and computed tomography. Immediate surgery saves life. CHB may improve on follow-up.>