Bae Kyungsoo, Jeon Kyung Nyeo, Lee Hyang-Im, Jang Jeong Yoon, Park Sung Eun, Ryu Kyeong Hwa, Baek Hye Jin, Choi Bo Hwa, Moon Jin Il, Cho Soo Buem
Department of Radiology, Gyeongsang National University School of Medicine, Institute of Health Sciences, Jinju, and Gyeongsang National University Changwon Hospital, Changwon Department of Pathology Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Medicine (Baltimore). 2017 Jun;96(23):e7112. doi: 10.1097/MD.0000000000007112.
Ruptured aneurysm originating from the left coronary sinus of Valsalva into the left ventricle (LV) is extremely rare. Imaging features of sinus aneurysm has been commonly reported using echocardiography or angiography. Here, we report multidetector computed tomography (MDCT) findings of left sinus of Valsalva aneurysm extending into the LV and caused severe aortic regurgitation (AR) in a 44-year-old male with latent infective endocarditis. The role of MDCT in preoperative surgical planning was also emphasized.
The patient visited our hospital due to worsening exertional dyspnea for 3 months.
On cardiac computed tomography (CT) using 320-MDCT, a saccular aneurysm arising from the left coronary sinus of Valsalva extending into the LV was diagnosed as the cause of severe AR.
The patient underwent resection of the aneurysm, aortic root reconstruction, and aortic valve replacement.
The patient made an uneventful recovery. Follow-up echocardiography showed no paravalvular leakage with improved LV function.
MDCT with wide coverage and high temporal resolution can provide exact and comprehensive information about complicated conditions, leading to confident surgical planning and successful management.
起源于瓦尔萨尔瓦左冠状动脉窦并破入左心室(LV)的动脉瘤极为罕见。鼻窦动脉瘤的影像学特征通常采用超声心动图或血管造影进行报道。在此,我们报告一例44岁患有潜在感染性心内膜炎的男性患者,其瓦尔萨尔瓦左窦动脉瘤延伸至左心室并导致严重主动脉瓣反流(AR)的多排螺旋计算机断层扫描(MDCT)表现。同时强调了MDCT在术前手术规划中的作用。
患者因进行性劳力性呼吸困难加重3个月前来我院就诊。
使用320排MDCT进行心脏计算机断层扫描(CT)时,诊断出一个起源于瓦尔萨尔瓦左冠状动脉窦并延伸至左心室的囊状动脉瘤是严重AR的病因。
患者接受了动脉瘤切除、主动脉根部重建和主动脉瓣置换术。
患者恢复顺利。随访超声心动图显示无瓣周漏,左心室功能改善。
具有广泛覆盖范围和高时间分辨率的MDCT可以提供有关复杂病情的确切和全面信息,从而实现自信的手术规划和成功的治疗管理。