Agrawal Yashwant, Chandrashekhar Rakshita, Pratt Jerry W, Cole Maria D, Kamath Sreenivas, Kalavakunta Jagadeesh K
Department of Internal Medicine/Pediatrics and Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI 49048, USA.
Department of Cardiology and Cardiothoracic Surgery, Borgess Medical Center, Kalamazoo, MI 49048, USA.
Case Rep Cardiol. 2015;2015:627946. doi: 10.1155/2015/627946. Epub 2015 Dec 27.
Ruptured noncoronary sinus of valsalva aneurysm with fistulous connections to multiple cardiac chambers has not been reported previously. We report a 66-year-old man who presented with worsening cough and exertional dyspnea. Transesophageal echocardiogram confirmed a large aneurysm involving the noncoronary cusp of the aortic sinus with aneurysmal extension to the left atrium. There were also two fistulous communications with the left atrium and one small fistulous connection with the right atrium. Open-heart surgery with aortic root replacement and reimplantation of coronary arteries along with primary closure and repair of aorta to the left atrial fistula was performed.
此前尚未有关于瓦氏窦非冠状动脉瘤破裂并与多个心腔形成瘘管连接的报道。我们报告一例66岁男性，表现为咳嗽加重和劳力性呼吸困难。经食管超声心动图证实有一个大动脉瘤累及主动脉窦的无冠瓣，并向左心房呈瘤样延伸。同时存在两个与左心房的瘘管交通以及一个与右心房的小瘘管连接。实施了心脏直视手术，包括主动脉根部置换、冠状动脉再植入，以及对主动脉至左心房瘘管进行一期闭合和修复。
