This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Taher, T. Articles by Graham, M. Search for Related Content PubMed PubMed Citation Articles by Taher, T. Articles by Graham, M. Related Collections Other heart failure CT and MRI Echocardiography Related Article

(Circulation. 2005;111:e101-e102.)
© 2005 American Heart Association, Inc.

Images in Cardiovascular Medicine

Sinus of Valsalva Rupture With Dissection Into the Interventricular Septum

Diagnosis by Echocardiography and Magnetic Resonance Imaging

Taha Taher, MD, FRCP(C); Rohit Singal, MD; Brian Sonnenberg, MD, FRCP(C); David Ross, MD, FRCS(C); Michelle Graham, MD, FRCP(C)

From the University of Alberta, Edmonton, Alberta, Canada.

Correspondence to Dr Taha Taher, 2C2 Division of Cardiology, Walter C. Mackenzie Health Sciences Centre, 8440 112th St, Edmonton, AB T6G 2B7, Canada. E-mail ttaher@yahoo.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 27-year-old previously healthy woman presented with a 3-month-long history of dyspnea after a nonspecific flu-like illness. Congestive heart failure was diagnosed clinically and confirmed radiographically. A transthoracic echocardiogram demonstrated rupture of the sinus of Valsalva with dissection into the interventricular septum (Figures 1 and 2). Severe early diastolic regurgitation into the false, noncommunicating cavity was observed within the septum, as well as moderate left ventricular chamber dilatation, distortion of the anteromedial papillary muscle, and consequent severe mitral regurgitation. A transesophageal echocardiogram showed the site of the rupture with flow into the false cavity (Figure 3, A and B). These findings were confirmed on magnetic resonance imaging (MRI; Figure 4). The patient was stabilized medically and underwent surgical repair. The postoperative transesophageal echocardiogram demonstrated elimination of the regurgitation into the false cavity and decreased mitral regurgitation (although still moderate) and a much smaller aneurysmal sac.

View larger version (94K): [in this window] [in a new window]   Figure 1. Transthoracic parasternal long-axis view of site of rupture (R) leading into the false cavity (FC). LV indicates left ventricle; LA, left atrium.

View larger version (102K): [in this window] [in a new window]   Figure 2. Transthoracic apical 4-chamber view of FC arising from dissection of the interventricular septum. Abbreviations as in Figure 1.

View larger version (46K): [in this window] [in a new window]   Figure 3. Transesophageal long-axis views. A, Aortic valve, demonstrating the dissection flap separating the left ventricular outflow tract (LVOT) from the FC. B, Aortic valve, demonstrating regurgitant flow (arrow) into the FC and LVOT. RV indicates right ventricle; other abbreviations as in Figure 1.

View larger version (101K): [in this window] [in a new window]   Figure 4. MRI of site of rupture (arrow) and FC. . . . [Full Text of this Article]

Related Article:

Issue Highlights
Circulation 2005 111: 829. [Extract] [Full Text]