Asymptomatic Ruptured Sinus of Valsalva Aneurysm Combined with Perimembranous Ventricular Septal Defect, and Bicuspid Aortic Valve in Adult Patient

Abstract

We report the case of an adult patient with the unusual combination of a perimembranous (PM) ventricular septal defect (VSD), asymptomatic ruptured sinus of Valsalva communicating with the right ventricle, and a bicuspid aortic valve. Bulged sinus of Valsalva might conceal the small PM VSD, therefore the patient had no symptom-associated VSD until grown up. However, when aortic valve regurgitation associated with prolapsed right aortic cusp worsened and ruptured sinus of Valsalva was found by echocardiogram, the patient underwent aortic valve replacement with anatomical surgical correction of the aortic sinus and VSD.

Keywords

ventricular septal defect - sinus of Valsalva rupture - bicuspid aortic valve

• References

• 1 Breccia G. Sopra un caso di morbo del Roger complicato con insufficienza aortica, decorso senza sintomi. Gazz d'osp Milano 1906; 27625
• 2 Ellis Jr FH, Ongley PA, Kirklin JW. Results of surgical treatment for congenital aortic stenosis. Circulation 1962; 25: 29-38
• 3 Tatsuno K, Konno S, Sakakibara S. Ventricular septal defect with aortic insufficiency. Angiocardiographic aspects and a new classification. Am Heart J 1973; 85 (1) 13-21
• 4 Kawashima Y, Danno M, Shimizu Y, Matsuda H, Miyamoto T. Ventricular septal defect associated with aortic insufficiency: anatomic classification and method of operation. Circulation 1973; 47 (5) 1057-1064
• 5 Van Praagh R, McNamara JJ. Anatomic types of ventricular septal defect with aortic insufficiency. Diagnostic and surgical considerations. Am Heart J 1968; 75 (5) 604-619
• 6 Nadas AS, Thilenius OG, Lafarge CG, Hauck AJ. Ventricular septal defect with aortic regurgitation: medical and pathologic aspects. Circulation 1964; 29: 862-873
• 7 Yacoub MH, Khan H, Stavri G, Shinebourne E, Radley-Smith R. Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of Valsalva, and ventricular septal defect. J Thorac Cardiovasc Surg 1997; 113 (2) 253-260 , discussion 261
• 8 Tatsuno K, Ando M, Takao A, Hatsune K, Konno S. Diagnostic importance of aortography in conal ventricular-septal defect. Am Heart J 1975; 89 (2) 171-177
• 9 Tohyama K, Satomi G, Momma K. Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect. Am J Cardiol 1997; 79 (9) 1285-1289
• 10 Halloran KH, Talner NS, Browne MJ. A study of ventricular septal defect associated with aortic insufficiency. Am Heart J 1965; 69: 320-326
• 11 Anastassiades CP, Chee CE, Petsas AA. Infundibular ventricular septal defect, aneurysm of the sinus of Valsalva, and bicuspid aortic valve in a Caucasian male. J Am Soc Echocardiogr 2005; 18 (3) 268-271