Kanzaki Yumiko, Terasaki Fumio, Fuji Shigeo, Kashiyama Tomokazu, Kaibe Shoji, Doi Yasuji, Kitaura Yasushi
Department of Internal Medicine III, Osaka Medical College, Takatsuki.
Intern Med. 2010;49(8):749-51. doi: 10.2169/internalmedicine.49.3089. Epub 2010 Apr 15.
A 61-year-old man was admitted to the hospital because of orthopnea and was diagnosed with heart failure with a continuous heart murmur. A transthoracic echocardiogram revealed turbulent flow from the right coronary sinus of Valsalva to the right atrium throughout the cardiac cycle. Aortography confirmed the presence of a shunt jet from the right coronary sinus of Valsalva to the right atrium. Cardiac catheterization revealed a left-right shunt rate of 47% and a pulmonary to systemic blood flow ratio of 1.81. Transesophageal echocardiography confirmed the existence of the shunt jet and revealed no deformity of the sinus of Valsalva. We report a rare case of sinus of Valsalva-right atrium fistula without typical aneurysmal formation.
一名61岁男性因端坐呼吸入院，被诊断为心力衰竭并伴有连续性心脏杂音。经胸超声心动图显示在整个心动周期中存在从瓦尔萨尔瓦右冠状动脉窦至右心房的湍流。主动脉造影证实存在从瓦尔萨尔瓦右冠状动脉窦至右心房的分流喷射。心导管检查显示左右分流率为47%，肺循环与体循环血流量之比为1.81。经食管超声心动图证实了分流喷射的存在，且未发现瓦尔萨尔瓦窦畸形。我们报告一例罕见的无典型动脉瘤形成的瓦尔萨尔瓦窦-右心房瘘病例。
