Rupture of Aneurysm of the Right Sinus of Valsalva Into the Right Ventricular Outflow Tract
Treatment With Amplatzer Atrial Septal Occluder
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.
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.
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.
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