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An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis

Echo Research & Practice volume 3, pages K1–K6 (2016)Cite this article

Summary

We present quite a rare case of extracardiac unruptured right sinus of valsalva aneurysm (SVA) complicated with atherothrombosis in a young adult man. A 35-year-old male with a giant unruptured SVA arising from the right coronary sinus (RCS) with extracardiac protrusion was diagnosed by echocardiography. Contrast-enhanced computed tomography (CT) revealed a huge calcified aneurysm with mural thrombi originating from the aortic root, and about 80% stenosis at the initial segment of the right coronary artery (RCA). Intraoperative exploration demonstrated a giant unruptured aneurysm arising from the RCS. Different from other SVAs reported before, this aneurismal wall appeared thick and atheromatous-like. In this aneurysm, there was a small localized intima tearing and mural thrombosis, and the orifice of the RCA was almost blocked. This patient underwent surgical patch repair to prevent aneurysm rupture and coronary artery bypass grafting for RCA revascularization. In conclusion, the pathological examination demonstrated marked foam cells, inflammatory cells, and thrombosis in the aneurismal wall.

References

  1. Cheng TO, Yang YL, Xie MX, Wang XF, Dong NG, Su W, Lü Q, He L, Lu XF, Wang J, Li L, Yuan L 2014. Echocardiographic diagnosis of sinus of Valsalva aneurysm: a 17-year (1995–2012) experience of 212 surgically treated patients from one single medical center in China. International Journal of Cardiology 173 33–39. (doi:10.1016/j.ijcard.2014.02.003)

    Article  Google Scholar 

  2. Ott DA 2006. Aneurysm of the sinus of Valsalva. Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 1 165–176. (doi:10.1053/j.pcsu.2006.02.014)

    Article  Google Scholar 

  3. Feldman DN, Roman MJ 2006. Aneurysms of sinuses of Valsalva. Cardiology 106 73–81.

    Article  Google Scholar 

  4. Cottogni M, Antretter H, Wicke K 1995. Subtotal rarefication of one aortic leaflet in a bicuspid aortic valve due to large aneurysm of left Valsalva’s sinus. Scandinavian Journal of Thoracic and Cardiovascular Surgery 29 87–90. (doi:10.3109/14017439509107209)

    Article  CAS  Google Scholar 

  5. Yasuda F, Shimono T, Adachi K, Onoda K, Tani K & Yada I 2000. Surgical repair of extracardiac unruptured acquired Valsalva aneurysms. Annals of Thoracic Surgery 70 1696–1698. (doi:10.1016/S0003-4975(00)01687-8)

    Article  CAS  Google Scholar 

  6. Nakagiri K, Kadowaki T, Morimoto N, Murakami H, Yoshida M &, Mukohara N 2012. Aortic root reimplantation for isolated sinus of Valsalva aneurysm in the patient with Marfan’s syndrome.. Annals of Thoracic Surgery 93 e49–e51. (doi:10.1016/j.athoracsur.2011.10.081)

    Article  Google Scholar 

  7. Lu S, Sun X, Wang C, Hong T, Xu D, Zhao W, Liu X 2013. Surgical correction of giant extracardiac unruptured aneurysm of the right coronary sinus of Valsalva: case report and review of the literature. General Thoracic and Cardiovascular Surgery 61 143–146. (doi:10.1007/s11748-012-0113-4)

    Article  Google Scholar 

  8. Brandt J, Jögi P & Lührs C 1985. Sinus of Valsalva aneurysm obstructing coronary arterial flow: case report and collective review of the literature. European Heart Journal 6 1069–1073.

    Article  CAS  Google Scholar 

  9. Polat N, Yildiz A, Yuksel M, Acet H, Alan S 2015. A thrombotic right sinus of Valsalva aneurysm causing acute myocardial infarction and ischemic stroke. Echocardiography 32 189–191. (doi:10.1111/echo.12755)

    Article  Google Scholar 

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Funding

This research is supported by grants (No. 81101053 and No. 81371581) from the National Natural Science Foundation of China.

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Authors and Affiliations

  1. Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Jun Zhang MD, Yani Liu MD PhD & Youbin Deng MD PhD

  2. Department of Cardiothoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Ligang Liu MD PhD

Authors
  1. Jun Zhang MD
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  2. Yani Liu MD PhD
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  3. Ligang Liu MD PhD
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  4. Youbin Deng MD PhD
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Correspondence to Yani Liu MD PhD.

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Zhang, J., Liu, Y., Liu, L. et al. An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis. Echo Res Pract 3, K1–K6 (2016). https://doi.org/10.1530/ERP-15-0028

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  • DOI: https://doi.org/10.1530/ERP-15-0028

Keywords

Echo Research & Practice

ISSN: 2055-0464

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