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Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve

Received: 24 August 2021    Accepted: 16 September 2021    Published: 30 September 2021
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Abstract

Backgroud: Valsalva sinus aneurysms are abnormalities of the heart that can be acquired or congenital. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency. Transcatheter closure has recently emerged as an alternative but surgery still has indications. Aim: We report our experience on the management of this pathology in a subsaharian country. Patient and method: We report the observation of a 7.5-year-old child whose discovery was fortuitous upon exploration of a heart murmur. Results: Doppler echocardiography made the diagnosis possible showing a large under pulmonary interventricular septal defect with a right left shunt, a small non-stenotic sub-aortic membrane, a bicuspid aortic valve without leakage or stenosis, a significant dilation of the aortic root. The surgical management was an intervention according to Tyrone-David technique with closure of the interventricular septal defect. Postoperative outcomes were simple and the short- to medium-term evolution favorable. Conclusion: Depending on the definition used to diagnose valsalva sinus aneurysms, the frequency of this pathology may be underestimated. What seems most appropriate to us is the definition considering the diameter of the sinuses relative to the body surface. An another endpoint is the need to explore the aortic root in the presence of interventricular communication and bicuspid aortic valve.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 7, Issue 4)
DOI 10.11648/j.ijcts.20210704.11
Page(s) 46-49
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Valsalva Sinus Aneurysm, Interventricular Septal Defect, Surgery

References
[1] Goldberg N., Krasnow N. Sinus of Valsalva aneurysms. Clin. Cardiol. 13, 831-836 (1990).
[2] Soichiro Henmi, Koki Yokawa, Yutaka Okita. Right ventricular outflow tract obstruction caused by sinus of Valsalva aneurysm. General Thoracic and Cardiovascular Surgery https://doi.org/10.1007/s11748-020-01546-5.
[3] Khakimjon Abralov, Amonjon Alimov. Short term results of sinus of Valsalva aneurysm repair. World Journal for Pediatric and Congenital Heart Surgery. 2017, Vol. 8 (1) 13-17.
[4] Liang Tang, Sheng-Hua Zhou, Zhen-Fei Fang. Transcatheter closure of ruptured sinus of Valsalva aneurysm with Double-disc perimembranous VSD occlude in man with mechanical aortic valve. Tex Heart Inst J 2019; 46 (3): 211-4.
[5] Saito C, Fukushima N, Fukushima K, Matsumura G, Ashihara K, Hagiwara N. Factors associated with aortic root dilatation after surgically repaired ventricular septal defect. Echocardiography. 2017; 00: 1–7.
[6] Bo Xu, Doygu Kocyigit, Carlos Godoy Rivas and al. Outcomes of contemporary imaging-guided management of sinus of Valsalva aneurysms. Cardiovasc Diagn Ther 2021; 11 (3): 770-780.
[7] Angeloni E, Vitaterna A, Pirelli M, et al. Effects of statin therapy on ascending aorta aneurysm growth: A propensity-matched analysis. Int J Cardiol 2015; 191: 52-5.
[8] Sambhunath Das, Suruchi Ladha, and Balram Airan. Unruptured sinus of Valsalva aneurysm with RVOT obstruction and supracristal ventricular septal defect-A rare combination. Echocardiography 2015; 32: 1322–1324.
[9] Kei Togashi, Francisco J, Gensini Paez, Richard Shen. Sinus of Valsalva aneurysm rupture associated with a ventricular septal defect: the importance of multi-Angle assessment by intraoperative transoesophageal echocardiography. Journal of Cardiothoracic and vascular anesthesia 000 (2020) 1-6 Article in Press.
[10] Wang Z. J, Zou C. W, Li D. C and al. Surgical repair of sinus of Valsalva aneurysm in Asian patients. Ann Thorac Surg 2007; 84: 156-60.
[11] Bo Xu, Kocyigit D, Betancor J and al. Sinus of Valsalva aneurysms: A state-of the Art Imaging Review. J Am Soc Echo cardiogr 2020; 33: 295-312.
[12] Cheng T. O, Yang Y. L, Xie M. X et al. 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. Int J Cardiol 2014; 173: 33-9.
[13] Violeta V. Groudeva Borislav G. Atzev Dimitar G. Petkov. Management of late presenting congenital combined heart defect-bicuspid aortic valve and ventricular septal aneurysm. Am J Case Rep, 2020; 21: e919766 DOI: 10.12659/AJCR.919766.
[14] Seung Hyun Lee, Jae Bum Kim, Nam Hee Park, Hyung Seop Kim, Dong Yoon Keum. Asymptomatic Ruptured sinus of Valsalva aneurysm combined with perimembranous ventricular septal defect, and bicuspid aortic valve in adult patient. Thoracic Cardiovasc Surg 2013; 61: 327-329.
[15] Pouya Nezafati, Mohammad Hassan Nezafati, and Hamid Hoseinikhah. Unruptured aneurysm of sinus of Valsalva coexisting with the large ventricular septal defect and severe aortic regurgitation in a young man. Case Reports in Medicine. Volume 2015, Article ID 396098, 3 pages http://dx.doi.org/10.1155/2015/396098.
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    Momar Sokhna Diop, Papa Salmane Ba, Papa Amath Diagne, Papa Ousmane Ba, Amadou Gabriel Ciss. (2021). Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve. International Journal of Cardiovascular and Thoracic Surgery, 7(4), 46-49. https://doi.org/10.11648/j.ijcts.20210704.11

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    ACS Style

    Momar Sokhna Diop; Papa Salmane Ba; Papa Amath Diagne; Papa Ousmane Ba; Amadou Gabriel Ciss. Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve. Int. J. Cardiovasc. Thorac. Surg. 2021, 7(4), 46-49. doi: 10.11648/j.ijcts.20210704.11

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    AMA Style

    Momar Sokhna Diop, Papa Salmane Ba, Papa Amath Diagne, Papa Ousmane Ba, Amadou Gabriel Ciss. Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve. Int J Cardiovasc Thorac Surg. 2021;7(4):46-49. doi: 10.11648/j.ijcts.20210704.11

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  • @article{10.11648/j.ijcts.20210704.11,
      author = {Momar Sokhna Diop and Papa Salmane Ba and Papa Amath Diagne and Papa Ousmane Ba and Amadou Gabriel Ciss},
      title = {Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {7},
      number = {4},
      pages = {46-49},
      doi = {10.11648/j.ijcts.20210704.11},
      url = {https://doi.org/10.11648/j.ijcts.20210704.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20210704.11},
      abstract = {Backgroud: Valsalva sinus aneurysms are abnormalities of the heart that can be acquired or congenital. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency. Transcatheter closure has recently emerged as an alternative but surgery still has indications. Aim: We report our experience on the management of this pathology in a subsaharian country. Patient and method: We report the observation of a 7.5-year-old child whose discovery was fortuitous upon exploration of a heart murmur. Results: Doppler echocardiography made the diagnosis possible showing a large under pulmonary interventricular septal defect with a right left shunt, a small non-stenotic sub-aortic membrane, a bicuspid aortic valve without leakage or stenosis, a significant dilation of the aortic root. The surgical management was an intervention according to Tyrone-David technique with closure of the interventricular septal defect. Postoperative outcomes were simple and the short- to medium-term evolution favorable. Conclusion: Depending on the definition used to diagnose valsalva sinus aneurysms, the frequency of this pathology may be underestimated. What seems most appropriate to us is the definition considering the diameter of the sinuses relative to the body surface. An another endpoint is the need to explore the aortic root in the presence of interventricular communication and bicuspid aortic valve.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve
    AU  - Momar Sokhna Diop
    AU  - Papa Salmane Ba
    AU  - Papa Amath Diagne
    AU  - Papa Ousmane Ba
    AU  - Amadou Gabriel Ciss
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    N1  - https://doi.org/10.11648/j.ijcts.20210704.11
    DO  - 10.11648/j.ijcts.20210704.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 46
    EP  - 49
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20210704.11
    AB  - Backgroud: Valsalva sinus aneurysms are abnormalities of the heart that can be acquired or congenital. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency. Transcatheter closure has recently emerged as an alternative but surgery still has indications. Aim: We report our experience on the management of this pathology in a subsaharian country. Patient and method: We report the observation of a 7.5-year-old child whose discovery was fortuitous upon exploration of a heart murmur. Results: Doppler echocardiography made the diagnosis possible showing a large under pulmonary interventricular septal defect with a right left shunt, a small non-stenotic sub-aortic membrane, a bicuspid aortic valve without leakage or stenosis, a significant dilation of the aortic root. The surgical management was an intervention according to Tyrone-David technique with closure of the interventricular septal defect. Postoperative outcomes were simple and the short- to medium-term evolution favorable. Conclusion: Depending on the definition used to diagnose valsalva sinus aneurysms, the frequency of this pathology may be underestimated. What seems most appropriate to us is the definition considering the diameter of the sinuses relative to the body surface. An another endpoint is the need to explore the aortic root in the presence of interventricular communication and bicuspid aortic valve.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Senegal

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