A 58-year-old man presenting with chest pain and dyspnea was diagnosed by trans esophageal echocardiography and cardiac catheterization to have the rare combination of ruptured aneurysm of noncoronary sinus of Valsalva into the right ventricle in associ ation with persistent left superior vena cava. These defects were confirmed at cardiac surgery. This case shows the importance of complementary use of invasive and noninva sive methods together in the diagnosis of rare combinations of lesions.
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References
1.
Abe T., Komatsu S.: Surgical repair and long-term results in ruptured sinus of Valsalva aneurysm . Ann Thorac Surg46:520-525, 1988.
2.
Boutefeu JM, Moret PR, Hahn C., et al: Aneurysms of the sinus of Valsalva. Am J Med65:18-24, 1978.
3.
Chiang CW, Lin FC, Fang BR, et al: Doppler and two-dimensional echocardiographic features of sinus of Valsalva aneurysm. Am Heart J116:1283-1288, 1988.
4.
Sakakibara S. , Konno S.: Congenital aneurysm of the sinus of Valsalva: Anatomy and classification. Am Heart J63:405-424, 1962.
5.
Venning GR: Aneurysms of the sinuses of Valsalva. Am Heart J42:57-69, 1951.
6.
Edwards JE, Burchell HB: The pathological anatomy of deficiencies between the aortic root and the heart, including aortic sinus aneurysms. Thorax12:125-139, 1957.
7.
Van Son JA, Danielson GK, Schaff HV, et al: Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation90(part 2):II-20-II-29, 1994.
8.
Chu SH, Hung CR, How SS, et al: Ruptured aneurysm of the sinus of Valsalva in Oriental patients . J Thorac Cardiovasc Surg99:288-298, 1990.
9.
Sundar AS, Fox KA: Anomalous origin of the right coronary artery from the pulmonary artery in association with congenital aneurysm of the sinus of Valsalva: Angiographic diagnosis of a rare association. Br Heart J68:330-332, 1992.
10.
Hurwitt E.: The surgical importance of a persistent left superior vena cava. Arch Dis Child34:1-4, 1959.
11.
Rubenfire M. , Evangelista J., Wajszczuk WJ, et al: Implication of a persistent left superior vena cava in transvenous pacemaker therapy and cardiac hemodynamic monitoring . Chest65:145-147, 1974.
12.
Spearman P. , Leier CV: Persistent left superior vena cava: Unusual wave contour of left jugular vein as the presenting feature . Am Heart J120:999-1002, 1990.
13.
Balasundarum S., Al-Haleesz, Duran CG: Persistent left superior vena cava . J Cardiovasc Surg32:59-61, 1991.
14.
Flynn MS, Castello R., McBride LW, et al: Ruptured congenital aneurysm of the sinus of Valsalva with persistent left superior vena cava imaged by intraoperative transesophageal echocardiography . Am Heart J125:1185-1187, 1993 .
