Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia
Yıl: 2010 Cilt: 38 Sayı: 6 Sayfa Aralığı: 419 - 421 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia
Öz: Valsalva sinüsü anevrizması, doğuştan kalp hastalığı olarak ya da kardiyak cerrahi girişimler sonucu ortaya çıkan nadir bir kardiyak sorundur. On dokuz yaşında erkek hasta göğüs ağrısı ve nefes darlığı yakınmalarıyla başvurdu. Oskültasyonda sol alt sternal sınırda ve Erb noktasında titreşim ile birlikte 4/6 dereceli erken diyastolik üfürüm duyuldu. İki taraflı bazal akciğer alanlarında krepitasyonlu raller vardı. Elektrokardiyogramda sağ dal bloku ve ST çökmesi görüldü. Troponin ve CK-MB düzeyleri yüksek bulundu. Yatıştan kısa süre sonra hastada ventrikül fibrilasyonu gelişti ve üç kez defibrilasyon uygulandı. Hemodinamik stabilizasyon sağlandıktan sonra yapılan transtorasik ekokardiyografide derece 4 aort yetersizliği, foramen ovale açıklığı ve sağ koroner sinüsten köken alan ve yırtılma sonucu sağ ventriküle giren Valsalva sinüsü anevrizması görüldü. Hastaya kardiyopulmoner baypass altında yırtılmış anevrizmanın ve foramen ovale açıklığının onarımı ve aort kapağı değişimi uygulandı. Ameliyatla ilgili ya da ameliyat sonrası takipte herhangi bir sorun yaşamayan hasta cerrahiden beş gün sonra taburcu edildi.
Anahtar Kelime: Konular:
Aort yetersizliği ve ciddi miyokart iskemisine yol açan yırtılmış Valsalva sinüsü anevrizması
Öz: Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly either presenting as a congenital heart disease or occurring secondary to cardiac surgical interventions. A 19-year-old male patient presented with chest pain and shortness of breath. On auscultation, a grade 4/6 early diastolic murmur was heard over the left lower sternal border and Erb’s area with a thrill. Crepitating rales were heard over bilateral basal lung fields. The electrocardiogram showed right bundle branch block and ST depression. Troponin and CK-MB levels were increased. Shortly after admission, he developed ventricular fibrillation and was defibrillated three times. After restoration of hemodynamic stabilization, transthoracic echocardiography was performed, which showed grade 4 aortic regurgitation, patent foramen ovale, and an aneurysm of the sinus of Valsalva arising from the right coronary sinus, with rupture into the right ventricle. The patient underwent surgery under cardiopulmonary bypass, for repair of the ruptured SVA and patent foramen ovale and aortic valve replacement. He was discharged on the fifth postoperative day following an uneventful operation and postoperative course.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
- 1. Au WK, Chiu SW, Mok CK, Lee WT, Cheung D, He GW. Repair of ruptured sinus of Valsalva aneurysm: determinants of long-term survival. Ann Thorac Surg 1998;66:1604-10.
- 2. Kouchoukos NT, Blackstone EH, Doty DB, Hanley FL, Karp RB, editors. Congenital sinus of Valsalva aneurysm and aortico-left ventricular tunnel. In: Kirklin/ Barratt-Boyes cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results and indications. Vol. 1, 3rd ed. Philadelphia: Churchill Livingstone; 2003. p. 911-27.
- 3. Vydt T, Smolders W, Rademakers F. A massive leftto right shunt due to a ruptured giant aneurysm of the sinus of Valsalva. Acta Cardiol 2002;57:449-51.
- 4. Brickner ME Congenital heart disease. In: Topol EJ, editor. Textbook of cardiovascular medicine. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 502-36.
- 5. Demirbağ R, Yıldız A, Yılmaz R, Cengiz M. Unruptured and ruptured sinus of Valsalva aneurysms in two cases. Türk Kardiyol Dern Arş 2008;36:178-80.
- 6. Sasson L, Katz MG, Ezri T, Tamir A, Rozenman Y, Geva Y, et al. Ruptured sinus of Valsalva aneurysm complicated by myocardial ischemia: pathogenetic mechanisms. Cardiovasc Pathol 2006;15:291-3.
- 7. van Son JA, Danielson GK, Schaff HV, Orszulak TA, Edwards WD, Seward JB. Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation 1994;90:II20-9.
- 8. Chu SH, Hung CR, How SS, Chang H, Wang SS, Tsai CH, et al. Ruptured aneurysms of the sinus of Valsalva in Oriental patients. J Thorac Cardiovasc Surg 1990;99:288-98.
| APA | YILDIZ A, ÇANĞA A, ŞEN N (2010). Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. , 419 - 421. |
| Chicago | YILDIZ Abdulkadir,ÇANĞA Aytun,ŞEN Nihat Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. (2010): 419 - 421. |
| MLA | YILDIZ Abdulkadir,ÇANĞA Aytun,ŞEN Nihat Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. , 2010, ss.419 - 421. |
| AMA | YILDIZ A,ÇANĞA A,ŞEN N Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. . 2010; 419 - 421. |
| Vancouver | YILDIZ A,ÇANĞA A,ŞEN N Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. . 2010; 419 - 421. |
| IEEE | YILDIZ A,ÇANĞA A,ŞEN N "Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia." , ss.419 - 421, 2010. |
| ISNAD | YILDIZ, Abdulkadir vd. "Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia". (2010), 419-421. |
| APA | YILDIZ A, ÇANĞA A, ŞEN N (2010). Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. Türk Kardiyoloji Derneği Arşivi, 38(6), 419 - 421. |
| Chicago | YILDIZ Abdulkadir,ÇANĞA Aytun,ŞEN Nihat Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. Türk Kardiyoloji Derneği Arşivi 38, no.6 (2010): 419 - 421. |
| MLA | YILDIZ Abdulkadir,ÇANĞA Aytun,ŞEN Nihat Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. Türk Kardiyoloji Derneği Arşivi, vol.38, no.6, 2010, ss.419 - 421. |
| AMA | YILDIZ A,ÇANĞA A,ŞEN N Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. Türk Kardiyoloji Derneği Arşivi. 2010; 38(6): 419 - 421. |
| Vancouver | YILDIZ A,ÇANĞA A,ŞEN N Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. Türk Kardiyoloji Derneği Arşivi. 2010; 38(6): 419 - 421. |
| IEEE | YILDIZ A,ÇANĞA A,ŞEN N "Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia." Türk Kardiyoloji Derneği Arşivi, 38, ss.419 - 421, 2010. |
| ISNAD | YILDIZ, Abdulkadir vd. "Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia". Türk Kardiyoloji Derneği Arşivi 38/6 (2010), 419-421. |
