Rupture of a left coronary sinus of Valsalva aneurysm into the left ventricle

Kazim Ergunes, Banu Lafci, Levent Yilik, Ismail Yurekli, Ismail Yurekli, Orhan Gokalp, Yuksel Besir, Yasar Gokkurt, Ali Gurbuz

Izmir Katip Celebi University Ataturk Training and Research Hospital, İZMİR, Turkey

Date, time and location: 2018.05.26 15:30, Exhibition area, 1st Floor. Zone – D

Abstract

Objective: Rupture of a left coronary sinus of Valsalva aneurysm into the left ventricle is very rare congenital anomaly. We present a 55-year-old man admitted to our department with palpitation.

Methods: At presentation, he had NYHA functional class II. Heart rate was 100 per minute. Electrocardiography showed sinus rhythm. Echocardiography showed rupture of a left coronary sinus of valsalva aneurysm into the left ventricle, and moderate aortic, mitral and tricuspit valve regurgitation. Left ventricular end-diastolic dimention was 58 mm. Angiography showed rupture of a left coronary sinus of valsalva aneurysm into the left ventricle.

Results: Surgical repair was performed through a median sternotomy under cardiopulmonary bypas with moderate hypothermia. The left ventrivle was vented. The aorta was cross-clamped and izothermic blood cardioplegia was infused. The defect in the sinus of Valsalva was repaired by pericardial patch closure. Peroperative transesophagial echocardiography showed minimal aortic and mitral valves regurgitation.Cross-clamp time was 40 minutes, and cardiopulmonary bypass time was 60 minutes. The patient was discharged 6 days after operation with methoprolol and acetylsalicylic acid treatment.

Conclusions: Surgical treatment ofrupture of a left coronary sinus of Valsalva aneurysm into the left ventricle is safe and effective.