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Eur J Cardiothorac Surg 2009;36:187. doi:10.1016/j.ejcts.2009.03.006
Copyright © 2009, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Giant unruptured noncoronary sinus of Valsalva aneurysm with ascending aorta dissection

Taner Sen*, Yesim Guray, Edjon Hajro, Burcu Mecit Demirkan

Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey

Received 19 January 2009; received in revised form 3 March 2009; accepted 9 March 2009.

* Corresponding author. Tel.: +90 532 706 40 56. (Email: medicineman_tr{at}hotmail.com).

Key Words: Aortic aneurysm • Sinus of Valsalva • Aortic dissection • Echocardiography

A 48-year-old woman was admitted with dyspnea. Echocardiography showed noncoronary sinus of Valsalva aneurysm (4.5 cm x 5.1 cm) compressing the left atrium. A flap-like appearance was visualized in this unruptured aneurysm (Fig. 1 , Videos 1 and 2). Computerized tomography revealed the aneurysm and the Debakey type 2 dissection flap (Fig. 2 ).


Figure 1
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  		Fig. 1. (A) In transthoracic echocardiography, the parasternal long axis view shows a cystic mass, a noncoronary sinus of Valsalva aneurysm, compressing the left atrium. (B) In the parasternal short axis view, the noncoronary sinus of Valsalva is aneurysmatic and a flap-like appearance (white arrow) can easily be seen. LV, left ventricle; LA, left atrium; RV, right ventricle; SVA, sinus of Valsalva aneurysm; NCC, noncoronary cusp; RCC, right coronary cusp; LCC, left coronary cusp; PV, pulmonary valve; PA, pulmonary artery.

 

Figure 2
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  		Fig. 2. Parts A, B and C are the computerized tomographic angiography images of different segments of the ascending aorta. The ascending aorta is dilated. The black arrow shows Debakey type 2 dissection flap at different segments of the ascending aorta.

 
Appendix A

Supplementary data

Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.ejcts.2009.03.006.





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