Ruptured Sinus of Valsalva Aneurysm Causing Aorto-Atrial Fistula and Acute Heart Failure: A Rare Encounter.

UNLABELLED

A ruptured sinus of Valsalva aneurysm as a cause of aorto-atrial fistula is very rare. We present the case of a 53-year-old female who presented with symptoms of acute heart failure and suspicion of an aorto-atrial fistula found on a transthoracic echocardiogram, which was confirmed on transesophageal echocardiography. A coronary angiogram showed normal coronary arteries but confirmed the right aorto-atrial fistula on aortogram. She underwent successful surgical repair of the fistula. Her postoperative echocardiogram showed a normal right atrium and right ventricle with no shunt. A ruptured sinus of Valsalva aneurysm is a devastating event and presents as acute heart failure. Prompt diagnosis and surgical repair is necessary to prevent mortality.

LEARNING POINTS

A ruptured sinus of Valsalva aneurysm causing an aorto-atrial fistula can present as acute heart failure.A transthoracic echocardiogram can identify the presence and location of a sinus of Valsalva aneurysm, while a transesophageal echocardiogram can recognize fistulous tract formation. Cardiac magnetic resonance imaging and computed tomography can confirm or better categorize echocardiographic findings.The management of an aorto-atrial fistula is surgical intervention, involving a patch repair.