Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
Circulation. 2002;105:e1-e2
doi: 10.1161/hc0102.100422
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Cullen, S.
Right arrow Articles by Redington, A. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cullen, S.
Right arrow Articles by Redington, A. N.
Related Collections
Right arrow Catheter-based coronary and valvular interventions: other
Right arrow Pediatric and congenital heart disease, including cardiovascular surgery
Right arrow Doppler ultrasound, Transcranial Doppler etc.

(Circulation. 2002;105:e1.)
© 2002 American Heart Association, Inc.


Images in Cardiovascular Medicine

Rupture of Aneurysm of the Right Sinus of Valsalva Into the Right Ventricular Outflow Tract

Treatment With Amplatzer Atrial Septal Occluder

Seamus Cullen, MB, BCh, BaO, FRCPI; Michael Vogel, MD, PhD; John E. Deanfield, MB, BChir, MRCP; Andrew N. Redington, MD, FRCP

From the Grown up Congenital Heart Department, Middlesex Hospital (S.C., M.V., J.E.D.) and Cardiac Unit, Great Ormond Street Hospital for Children, NHS Trust, (A.N.R.), London, UK.

Correspondence to Andrew Redington, Hospital for Sick Children, Toronto, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. E-mail andrew.redington{at}sickkids.ca

A 40-year-old asymptomatic woman who had been followed elsewhere for a presumed small ventricular septal defect and mild aortic regurgitation presented to our unit with a continuous heart murmur. Transthoracic ECG confirmed the diagnosis of a ruptured aneurysm of the right sinus of Valsalva into the right ventricular (RV) outflow tract. Under general anesthesia, a transesophageal echocardiogram (TEE) was performed (Figure 1), which demonstrated a rupture of the right sinus of Valsalva into the RV outflow tract. After angiography (Figure 2), a 6-mm Amplatzer septal occluder was placed through the RV outflow tract. TEE and angiog-raphy (Figure 3) confirmed a good position of the device and no residual shunting, as well as no obstruction to the RV outflow tract or the coronary arteries. The patient was discharged the following day. Transcatheter closure is an effective treatment for a ruptured aneurysm of a sinus of Valsalva in selected cases.



View larger version (35K):
[in this window]
[in a new window]
 
Figure 1. TEE of the left and right ventricular outflow tracts. The B-mode image (left) demonstrated the aneurysm and its rupture into the RV outflow tract. Color Doppler (right) showed the turbulent flow through the rupture and trivial aortic valve regurgitation.



View larger version (106K):
[in this window]
[in a new window]
 
Figure 2. Angiography of the aortic root confirmed a ruptured aneurysm of the sinus of Valsava (arrow) into the RV outflow tract (left). Aortic root angiography after placement of the Amplatzer device (right) demonstrated correct position of the device (arrows). Ao indicates aorta; RVO, RV outflow tract.



View larger version (78K):
[in this window]
[in a new window]
 
Figure 3. TEE confirmed that the device had occluded the communication between the aortic root (Ao) and the RV outflow tract (RVO). LV indicates left ventricle.

Acknowledgments

Research at the Institute of Child Health and Great Ormond Street Hospital for Children National Health Service (NHS) Trust benefits from research and development funding received from the NHS Executive.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University Of Texas Medical School and Baylor College of Medicine.

Circulation encourages its readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MCI-267, Houston, TX 77030.





This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Cullen, S.
Right arrow Articles by Redington, A. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cullen, S.
Right arrow Articles by Redington, A. N.
Related Collections
Right arrow Catheter-based coronary and valvular interventions: other
Right arrow Pediatric and congenital heart disease, including cardiovascular surgery
Right arrow Doppler ultrasound, Transcranial Doppler etc.