Anzai N, Yamada M, Tuchida K, Akiyama K, Iida Y
Cardiology. 1987;74(2):147-50. doi: 10.1159/000174189.
Rupture of an aneurysm of the aortic sinus of Valsalva into the right ventricle is described. Surgery revealed a small aneurysm ruptured into the right ventricle near the tricuspid valve without aneurysmal involvement of the tricuspid valve. The cineangiogram revealed a shunt from the aortic sinus into the right atrium not during systole but during diastole, and increased oxygen saturation was found in the right atrium. The unusual hemodynamics in this case was most probably due to the closure of the small aneurysmal opening due to myocardial contraction during systole, so that the shunt flow through the aneurysmal tract occurred only during diastole and was directed toward the right atrium due to the location of the aneurysm. Thus, even without aneurysmal involvement of the tricuspid valve or tricuspid regurgitation, the oxygen saturation increased in the right atrium.
描述了瓦氏窦瘤破裂进入右心室的情况。手术发现一个小动脉瘤在三尖瓣附近破裂进入右心室，三尖瓣未受动脉瘤累及。电影血管造影显示，分流并非发生在收缩期，而是在舒张期从主动脉窦进入右心房，且右心房的氧饱和度升高。该病例中异常的血流动力学很可能是由于收缩期心肌收缩导致小动脉瘤开口关闭，使得经动脉瘤通道的分流仅在舒张期发生，并且由于动脉瘤的位置，分流指向右心房。因此，即使三尖瓣未受动脉瘤累及或无三尖瓣反流，右心房的氧饱和度仍会升高。
