to report a rare case of rupture of aneurysm of the right sinus of Valsalva (R-SOVA),
associated with ventricular septal defect (VSD).
Methods and Materials
A sinus of Valsalva aneurysm is an uncommon cardiac anomaly,
defined as dilatation of one of the three aortic sinuses between the aortic valve anulus and the sino tubularjunction or supra-aortic ridge.
A 55-year-old African male with no past medical history presented to the Emergency Room with dyspnea,
palpitation and angina-like chest pain.
The trans-thoracic-echocardiography (TTE) revealed right heart chambers’ enlargement,
mitral valve prolapse,
aneurysmal dilatation of the right coronary sinus of Valsalva protruding in the right ventricular outflow tract (RVOT),
A coronary angiography was not performed due to the close proximity of the aneurysm to the right coronary artery ostium.
So he underwent computed tomography scan,
which confirmed the saccular R-SOVA (diameter 15 mm),
extending towards the right ventricle (Fig.1 and 3) and the presence of a perimembranousVSD just below the valve plane (Fig.
The aneurysm determined a distortion of pulmonic valve leaflets causing pulmonary insufficiency.
CT coronary angiography showed no coronary stenosis.
The right coronary artery ostium arised 8 mm above the R-SOVA....
in addition to TTE,
can play a complementary or confirmatory role in diagnosis and surgical planning,
providing with a better 3D appreciation and with important information about the coronary tree and the distance between the sinus aneurysm and the coronary artery ostium.
it permits accurate diagnostic imaging of even small SOVAs in a dynamic setting.
Dipartimento interdisciplinare di Medicina,
Sezione di Diagnostica per Immagini,
Università degli Studi di Bari “Aldo Moro”,
Aneurysms of the sinuses of Valsalva.