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Chirurgia 2016 October;29(5):174-7

language: English

Unruptured left sinus of Valsalva aneurysm with fistulous track complicated by aortic regurgitation

Satoshi YAMASHIRO, Ryoko ARAKAKI, Yuya KISE, Hitoshi INAFUKU, Yukio KUNIYOSHI

Department of Thoracic and Cardiovascular Surgery, Graduate school of Medicine, University of the Ryukyus, Okinawa, Japan


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Sinus of Valsalva aneurysms are relatively uncommon, while unruptured sinus of Valsalva aneurysm in the left coronary sinus is rare. A 54-year-old female was admitted for palpitations and general fatigue. Transthoracic echocardiogram revealed severe aortic regurgitation and Valsalva aneurysm of the left coronary sinus. Multi-slice computed tomography demonstrated diffuse aneurysmal dilatation of the left sinus of Valsalva without rupture. We performed a modified Bentall procedure. The optimal management of an asymptomatic, unruptured sinus of Valsalva aneurysm is not known, because the precise natural history of this phenomenon has not been well characterized. However, early surgery is recommended, because it provides excellent outcomes in such cases. The precise repair technique is dependent on the number of dilated sinuses, whether the aneurysm has ruptured, and whether the aneurysm has an orifice.

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