Author + information
- Received December 10, 2009
- Revision received January 12, 2010
- Accepted January 12, 2010
- Published online October 12, 2010.
- Darach O h-Icí, MD,
- Marie-Christine Malergue, MD,
- Jérôme Garot, MD, PhD and
- Jean-François Piéchaud, MD
An asymptomatic 23-year-old man was noted to have a harsh pansystolic murmur on examination. Transthoracic echocardiography revealed a ruptured sinus of Valsalva (SOV), which was confirmed on transesophageal echocardiography (TEE) (A, Online Video 1). The relation between the rupture, right atrium (RA), and aortic valve (Ao) can be clearly seen (B, Online Videos 2and 3). Using fluoroscopic and real-time 3-dimensional TEE guidance, the defect was closed with an Amplatzer septal closure device (C and D, arrows, Online Videos 4, 5, 6, 7, 8, and 9). This case demonstrates the utility of real-time 3-dimensional TEE in assisting the diagnosis and percutaneous treatment of cardiac defects.
Sinus of Valsalva rupture is rare (1). Untreated, it carries a risk of development of right ventricular (RV) overload and pulmonary hypertension. Aneurysms arising from the right coronary sinus are the most common, and usually extend and rupture into the right-side heart chambers (1). LA = left atrium.
- Received December 10, 2009.
- Revision received January 12, 2010.
- Accepted January 12, 2010.
- American College of Cardiology Foundation