Ruptured Sinus of Valsalva Aneurysm from Left Coronary Sinus with Different Causes

Research Article

Austin J Clin Ophthalmol. 2022; 9(1): 1125.

Ruptured Sinus of Valsalva Aneurysm from Left Coronary Sinus with Different Causes

Kang R1#, Han M2# and Zhang C1*

¹Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

²Queen Mary School, Nanchang University, Nanchang, Jiangxi, China

#Contributed Equally to this Work and regarded as Co-First Authors

*Corresponding author: Chunquan Zhang, Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, Jiangxi, 330006, China

Received: February 12, 2022; Accepted: March 08, 2022; Published: March 15, 2022

Abstract

Objective: Analysis of three cases in which the clinical diagnosis was ruptured sinus of Valsalva aneurysm (RSVA) from left coronary sinus, combined with similar cases in the literature, to summarize the etiology of RSVA.

Methods: Retrospective analysis of three cases of RSVA diagnosed in our hospital from 2009 to 2021. Their general condition, examination and treatment were analyzed, and the etiology of the sinus of Valsalva aneurysm (SVA) was summarized in relation to similar cases reported in the literature.

Results: All three cases were diagnosed as RSVA from left coronary sinus with a clear etiology of congenital SVA, Behcet’s disease and infective endocarditis, respectively. They all underwent successful surgical treatment. In the literature, there were 12 cases of SVA from left coronary sinus of definite etiology, 10 of which ruptured.

Conclusions: SVA from left coronary sinus is a rare disease with a complex etiology, and RSVA is one of the most serious complications of SVA. Exploring the etiology of SVA will help to prevent the serious complications of RSVA by targeting the etiology for treatment and timely surgical intervention.

Keywords: Sinus of Valsalva aneurysm; Left sinus; Ruptured; Etiology; Behcet’s disease; Infective endocarditis

Abbreviations

RSVA: Ruptured Sinus of Valsalva Aneurysm; SVA: Sinus of Valsalva Aneurysm; IE: Infective Endocarditis; BD: Behcet’s Disease; BP: Blood Pressure; HR: Heart Rate; RR: Respiratory Rate; ESR: Erythrocyte Sedimentation Rate; B-BNP: B-Type Brain Natriuretic Peptide; ANA: Anti Nuclear Antibody; anti-dsDNA: Antibody, Anti Double Strand DNA Antibody; TTE: Transthoracic Echocardiography; LV: Left Ventricle; LVOT: Left Ventricular Outflow Tract; LA: Left Atrium; CTA: Computed Tomography Angiography; AR: Aortic Regurgitation

Introduction

Sinus of Valsalva Aneurysm (SVA) is an unusual aortic root defect that can be dangerous due to its serious complications; it is defined as dilatation of one or more of the aortic valve sinuses [1]. According to Meier JH et al., SVA commonly arise from the right sinus, (65%~85%), less commonly from noncoronary sinus (10%~30%), and rarely (<5%) from the left sinus [2]. It can be either a congenital or acquired cardiac anomaly [3], and is relatively common in oriental patients4.Congenital SVA is owing to a dilatation generally of a single sinus of Valsalva caused by a separation between the aortic media and the annulus fibrosus, and often with a deficiency of the normal elastic tissue and abnormal development of the bulbus cordis [5]. Congenital SVA is usually seen in patients with Marfan or Ehlers-Danlos syndrome [6]. Acquired SVA is mainly the results of infective endocarditis (IE), syphilis, trauma, Behcet’s disease (BD), atherosclerosis, cystic medionecrosis [7,8].

Although surgical repairs for ruptured sinus of valsalva aneurysm (RSVA) are gradually matured, RSVA is still considered as a special and fetal complication of SVA with severe mortality and morbidit [5]. So it is more revelatory that we focus on the etiology of RSVA from left coronary sinus, for this rare situation is easily neglected and usually fetal. However, there are few cases of RSVA from left coronary sinus and fewer studies on the etiology of SVA at present. Therefore, this paper retrospectively analyzed and reported 3 cases of RSVA from left coronary sinus that occurred in our hospital from 2009 to 2021. 12 cases of SVA from left coronary sinus with a clear cause were also obtained from the literature. And the etiology of SVA was summarized in relation to similar cases reported in the literature.

Our cases reported in this article are remarkable for several reasons: Etiology of SVA, site of rupture, precise preoperative diagnosis and the successful surgical management. By exploring the etiology of SVA will help to prevent the serious complications of RSVA by targeting the etiology for treatment and timely surgical intervention.

Materials and Methods

We retrospectively analyzed three patients with RSVA from 2009 to 2021 IN our hospital and obtained their preoperative, intraoperative, and postoperative conditions. Also, by reviewing the literature, we obtained 12 cases of SVA from left coronary sinus with clear causes [9-20]. We also retrospectively analyzed the etiology of these 12 patients.

Results

See Table 1 and 2.