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(Circulation. 2004;110:e515.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Giant Unruptured Noncoronary Sinus of Valsalva Aneurysm

Ozan Utuk, MD; Ozgur Bayturan, MD; Ali R. Bilge, MD; Hakan Tikiz, MD; Ugur K. Tezcan, MD

From the Department of Cardiology, Celal Bayar University Hospital, Manisa, Turkey.

Correspondence to Dr Ozan Utuk, Celal Bayar University Hospital, Department of Cardiology, 45020 Manisa, Turkey. E-mail ozanutuk@hotmail.com

An extract of the first 100% of the full text is provided, because this article has no abstract.

A 66-year-old woman presented with dyspnea on exertion (NYHA class II), which she had been experiencing for 2 years. An examination revealed normal systolic and diastolic blood pressures and a grade 2/6 continuous murmur on the left side of the sternum. The transthoracic echocardiogram showed serious aortic regurgitation and a pulsating cystic mass (7.0x6.11 cm) extending from the ascending aorta and protruding into the right and left atria. No thrombus had been visualized in this unruptured cystic mass with clear borders (Figures 1 to 3). Contrast aortography after left catheterization confirmed the presence of an unruptured giant aortic aneurysm of the noncoronary sinus and serious aortic insufficiency (Figure 4). No shunt was revealed, and the patient had normal coronary arteries. The patient was referred for surgical repair of the lesion.

View larger version (127K): [in this window] [in a new window]   Figure 1. Transthoracic echocardiogram of apical 4-chamber view showing a cystic mass with clear borders protruding in both atria. LV indicates left ventricle; RV, right ventricle; LA, left atrium; and RA, right atrium.

View larger version (113K): [in this window] [in a new window]   Figure 2. Apical 5-chamber view revealing the connection of the cystic mass with ascending aorta. AO indicates aorta; other abbreviations as in Figure 1.

View larger version (134K): [in this window] [in a new window]   Figure 3. Parasternal short-axis view revealing the origin of cystic mass from the noncoronary sinus of Valsalva. RCC indicates right coronary cusp; LCC, left coronary cusp; RVOT, right ventricle outflow tract; and PA, pulmonary artery.

View larger version (167K): [in this window] [in a new window]   Figure 4. Angiography of the aortic root confirming the giant aneurysm of the sinus of Valsalva and serious aortic regurgitation.

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Circulation 2004 110: 3399. [Extract] [Full Text]