The authors describe an incidental finding of a rare type of aneurysmal fistula of the right coronary sinus dissecting through the interventricular septum and communicating with the coronary sinus. Transthoracic and transesophageal echocardiography were the major tools of detecting and delineating its origin and course, which was further proved by cardiac angiography. With the help of transesophageal echocardiography, the fistula could be closed successfully by catheter coil embolization. To the authors' knowledge, this is the first report of coil embolization to manage such a lesion in the interventricular septum.
Takach TJ, Reul GJ, Duncan JM, et al: Sinus of Valsalva aneurysm or fistula: management and outcome. Ann Thorac Surg1999;68:1573–1577.
2.
Chu SH, Hung CR, How SS, et al: Ruptured aneurysm of the sinus of Valsalva in Oriental patients. J Thorac Cardiovasc Surg1990;99:288–298.
3.
Walters MI, Ettles D, Guvendik L, Kaye GC: Interventricular septal expansion of a sinus of Valsalva aneurysm: a rare cause of complete heart block. Heart1998;80:202–207.
4.
Abad C: Congenital aneurysm of the sinus of Valsalva dissecting into the interventricular septum. Cardiovasc Surg1995;3:563–564.
5.
Engel PJ, Held JS, Bel-Kahn J, Spitz H: Echocardiographic diagnosis of congenital sinus of Valsalva aneurysm with dissection of the interventricular septum. Circulation1981;63:705–711.
6.
Raffa H, Masieu J, Sorefan A, Kayali MT: Sinus of Valsalva aneurysm eroding into the interventricular septum. Ann Thorc Surg1999;51:996–998.
7.
Koh KK, Lee KH, Kim SS, et al: Ruptured aneurysm of sinus of Valsalva in a patient of Behcet's disease. Int Cardiol1994;47:177–179.
