PDF(Pubmed)
Abstract：
In this report, we present a case of left-right sinus fusion in a Ruptured sinus of Valsalva aneurysm (RSVA) that perforated into the myocardium, giving rise to myocardial dissection. The existence of an anomalous bicuspid aortic valve (BAV) is contemplated as a potential etiological element in this context. Employing multimodal imaging modalities, encompassing transthoracic echocardiography and computed tomography (CT), facilitated the visualization of a dissecting hematoma situated within the myocardium subsequent to the RSVA. Following this, our patient underwent an Cabrol surgical intervention, received patch repair, and underwent mitral valve annuloplasty, during which a three-year period transpired without the occurrence of any deleterious cardiac events. In summary, this report establishes the cornerstone for the surgical intervention of RSVA, shedding light on the efficacious handling of RSVA-associated myocardial dissection. It posits that the presence of a BAV may serve as a predisposing factor to RSVA rupture, potentially elevating the susceptibility to myocardial dissection. The utilization of diverse multimodal imaging methodologies played an indispensable role in the detection of a hematoma within the myocardial tissue subsequent to the RSVA rupture. The uneventful three-year postoperative follow-up of the patient underscores the efficacy of the undertaken interventions.
摘要：
在这份报告中,我们介绍了一例在Valsalva动脉瘤（RSVA）破裂的窦中进行左-右窦融合的情况，引起心肌夹层.在这种情况下，反常的二叶主动脉瓣（BAV）的存在被认为是潜在的病因。采用多模态成像模式，包括经胸超声心动图和计算机断层扫描（CT），促进了RSVA后心肌内夹层血肿的可视化。在此之后,我们的病人接受了Cabrol手术干预,收到补丁修复，做了二尖瓣瓣环成形术,在3年的时间内没有发生任何有害的心脏事件。总之,本报告为RSVA的手术干预奠定了基础，阐明RSVA相关心肌夹层的有效处理。假设BAV的存在可能是RSVA破裂的诱发因素，有可能提高心肌夹层的易感性.多种多模态成像方法的利用在RSVA破裂后检测心肌组织内的血肿中起着不可或缺的作用。患者术后三年的顺利随访强调了所采取干预措施的有效性。
