Ruptured Sinus of Valsalva Aneurysm Causing Aorto–Atrial Fistula and Acute Heart Failure: A Rare Encounter

  • Zafar Ali University of Kansas Medical Center, Kansas City, KS, USA
  • Talal Asif John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA
  • Justin Sheehy University of Missouri–Kansas City, Kansas City, MO, USA
  • Dany Jacob University of Missouri–Kansas City, Kansas City, MO, USA
  • Paramdeep S Baweja University of Missouri–Kansas City, Kansas City, MO, USA
DOI: https://doi.org/10.12890/2020_001499

Keywords

Sinus of Valsalva aneurysm, aorto–atrial fistula, heart failure

Abstract

A ruptured sinus of Valsalva aneurysm as a cause of aorto–atrial fistula is very rare. We present the case of a 53-year-old female who presented with symptoms of acute heart failure and suspicion of an aorto–atrial fistula found on a transthoracic echocardiogram, which was confirmed on transesophageal echocardiography. A coronary angiogram showed normal coronary arteries but confirmed the right aorto–atrial fistula on aortogram. She underwent successful surgical repair of the fistula. Her postoperative echocardiogram showed a normal right atrium and right ventricle with no shunt. A ruptured sinus of Valsalva aneurysm is a devastating event and presents as acute heart failure. Prompt diagnosis and surgical repair is necessary to prevent mortality.

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References

  • Liu F, Zhu Z, Ren J, Mu J. A rare cause of sudden dyspnea and unexpected death in adolescence: fistula from aortic sinus of Valsalva to right atrium. Int J Clin Exp Med 2014;7(9):2945–2947.

  • Moustafa S, Mookadam F, Cooper L, Adam G, Zehr K, Stulak J, et al. Sinus of Valsalva aneurysms – 47 years of a single center experience and systematic overview of published reports. Am J Cardiol 2007;99(8):1159–1164.

  • Liu S, Xu X, Ding X, Liu G, Zhao Z, Zhao X, et al. Comparison of immediate results and mid-term follow-up of surgical and percutaneous closure of ruptured sinus of Valsalva aneurysm. J Cardiol 2014;63(3):239–243.

  • Nabati M, Ghaffari R, Ghaemian A. Rupture of a noncoronary sinus of Valsalva aneurysm into the left atrium: a rare cause of acute pulmonary edema. Echocardiography 2013;30(10):e315–e318.

  • Shah BN, Livesey SA, Rakhit DJ. Aorto–atrial fistula in the absence of infective endocarditis: diagnosis by 2- and 3-dimensional transesophageal echocardiography. Tex Heart Inst J 2012;39(1):146–147.

  • Ananthasubramaniam K. Clinical and echocardiographic features of aorto–atrial fistulas. Cardiovasc Ultrasound 2005;3:1.

  • Arikan E, Karagöz A, Bayata S, Yilik L, Ünlüer EE. A rare cause of dyspnea: sudden rupture of aortic Valsalva sinus aneurysm. Case Rep Med 2013;909302.

  • Jugpal TS, Dixit R, Lohchab S, Garg A. Giant unruptured sinus of Valsalva aneurysm: an unusual cause of right heart failure. J Clin Imaging Sci 2015;5:64.

  • Vural KM, ?ener E, Ta?demir O, Bayazit K. Approach to sinus of Valsalva aneurysms: a review of 53 cases.Eur J Cardiothorac Surg 2001;20(1):71–76.

  • Cheng TO, Yang YL, Xie MX, Wang XF, Dong NG, Su W, 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(1):33–39.

  • Takach TJ, Reul GJ, Duncan JM, Cooley DA, Livesay JJ, Ott DA, et al. Sinus of Valsalva aneurysm or fistula: management and outcome. Ann Thorac Surg 1999;68(5):1573–1577.

  • Tong S, Zhong L, Liu J, Yao Q, Guo Y, Shu M, et al. The immediate and follow-up results of transcatheter occlusion of the ruptured sinus of Valsalva aneurysm with duct occluder. J Invasive Cardiol 2014;26(2):55–59.

    • Published: 2020-03-06

    Issue: Vol 7 No 4 (view)

    Section: Articles

    How to cite:
    1.
    Ali Z, Asif T, Sheehy J, Jacob D, Baweja PS. Ruptured Sinus of Valsalva Aneurysm Causing Aorto–Atrial Fistula and Acute Heart Failure: A Rare Encounter. EJCRIM 2020;7 doi:10.12890/2020_001499.