PDF(Pubmed)
Abstract：
UNASSIGNED: Sinus of valsalva aneurysms (SOVAs) are infrequent findings and generally diagnosed incidentally. A SOVA may be at risk for rupture, which would lead to an aorto-cardiac shunt. These patients present similarly to decompensated heart failure.
UNASSIGNED: We present a case of a 44-year-old female with a ruptured non-coronary SOVA diagnosed by echocardiogram during evaluation for exertional dyspnoea. A trans-oesophageal echocardiogram (TEE) revealed a 2.1 cm non-coronary SOVA with windsock communication to the right atrium. The patient refused surgery, and two years later, presented with florid right heart failure with preserved left ventricular function. The right ventricle was severely dilated and hypokinetic with right atrial enlargement. After finally agreeing to surgery, a pre-operative catheterization revealed non-obstructive coronaries and a significant left to right shunt with elevated pulmonary pressure. The patient had suboptimal response to diuretic therapy and was sent for successful repair of the aneurysm with the closure of the aorto-atrial fistula via bovine pericardial patch and resolution of the left to right shunt as demonstrated by intra-operative TEE. Her right-sided heart failure symptoms subsequently resolved.
UNASSIGNED: SOVA is a rare finding but should still be considered in the differential in young and middle-aged patients with symptoms of acute heart failure, hemodynamic compromise, and a new continuous heart murmur. Early surgical repair is highly recommended to prevent acute and long-term complications.
UNASSIGNED: We present a case of a 44-year-old female with a ruptured non-coronary SOVA diagnosed by echocardiogram during evaluation for exertional dyspnoea. A trans-oesophageal echocardiogram (TEE) revealed a 2.1 cm non-coronary SOVA with windsock communication to the right atrium. The patient refused surgery, and two years later, presented with florid right heart failure with preserved left ventricular function. The right ventricle was severely dilated and hypokinetic with right atrial enlargement. After finally agreeing to surgery, a pre-operative catheterization revealed non-obstructive coronaries and a significant left to right shunt with elevated pulmonary pressure. The patient had suboptimal response to diuretic therapy and was sent for successful repair of the aneurysm with the closure of the aorto-atrial fistula via bovine pericardial patch and resolution of the left to right shunt as demonstrated by intra-operative TEE. Her right-sided heart failure symptoms subsequently resolved.
UNASSIGNED: SOVA is a rare finding but should still be considered in the differential in young and middle-aged patients with symptoms of acute heart failure, hemodynamic compromise, and a new continuous heart murmur. Early surgical repair is highly recommended to prevent acute and long-term complications.
摘要：
未经证实：valsalva动脉瘤窦（SOVA）是罕见的发现，通常是偶然诊断的。SOVA可能有破裂的风险，会导致主动脉心脏分流.这些患者表现类似于失代偿性心力衰竭。
UNASSIGNED：我们介绍了一例44岁女性患者，在评估劳累性呼吸困难时通过超声心动图诊断为非冠状动脉SOVA破裂。经食道超声心动图（TEE）显示2.1厘米的非冠状动脉SOVA，与右心房有挡风玻璃通讯。病人拒绝手术,两年后,表现为右心衰竭，左心室功能保留。右心室严重扩张，运动不足，右心房扩大。在最终同意手术后,术前导管插入术显示冠状动脉非梗阻性和显著的左向右分流伴肺压升高.患者对利尿剂治疗的反应欠佳，并被送去成功修复动脉瘤，通过牛心包补片闭合主动脉心房瘘，并通过术中TEE证明左向右分流。她的右侧心力衰竭症状随后消失。
未经证实：SOVA是一个罕见的发现，但仍应在有急性心力衰竭症状的中青年患者中加以考虑。血液动力学妥协，和一个新的持续的心脏杂音。强烈建议早期手术修复以防止急性和长期并发症。
UNASSIGNED：我们介绍了一例44岁女性患者，在评估劳累性呼吸困难时通过超声心动图诊断为非冠状动脉SOVA破裂。经食道超声心动图（TEE）显示2.1厘米的非冠状动脉SOVA，与右心房有挡风玻璃通讯。病人拒绝手术,两年后,表现为右心衰竭，左心室功能保留。右心室严重扩张，运动不足，右心房扩大。在最终同意手术后,术前导管插入术显示冠状动脉非梗阻性和显著的左向右分流伴肺压升高.患者对利尿剂治疗的反应欠佳，并被送去成功修复动脉瘤，通过牛心包补片闭合主动脉心房瘘，并通过术中TEE证明左向右分流。她的右侧心力衰竭症状随后消失。
未经证实：SOVA是一个罕见的发现，但仍应在有急性心力衰竭症状的中青年患者中加以考虑。血液动力学妥协，和一个新的持续的心脏杂音。强烈建议早期手术修复以防止急性和长期并发症。
