Abduallah Yaqeen, Azzouz Safaa, Singh Kelita, Deschenes Marc, Sebastiani Giada
Department of Medicine, Royal Victoria Hospital, McGill University Health Centre, Montréal, Québec, Canada.
The authors equally contributed to this work.
Can Liver J. 2021 Nov 11;4(4):430-432. doi: 10.3138/canlivj-2021-0012. eCollection 2021 Fall.
A sinus of Valsalva aneurysm (SOVA) is a rare cardiac defect in which the aortic root area between the aortic annulus and the sinotubular junction is dilated. We present a case of acute liver failure (ALF) in a 21-year-old man secondary to ruptured SOVA inducing severe ischemic hepatitis. The patient presented clinically with classical ALF. The liver ultrasound reported hepatomegaly with pulsatile portal flow and dilated hepatic veins. A transthoracic echocardiogram revealed focal aneurysmal dilatation of the aortic root with flow across the aneurysm toward the right atrium and elevated right chambers pressures. The surgical repair of the non-coronary SOVA was successful, and post-operatively, liver transaminases improved, and ALF resolved. Given that ruptured SOVA can be surgically repaired, hepatologists should be aware of this diagnosis in a young patient with ALF.
瓦氏窦瘤（SOVA）是一种罕见的心脏缺陷，其中主动脉瓣环和窦管交界处之间的主动脉根部区域扩张。我们报告一例21岁男性因SOVA破裂继发严重缺血性肝炎导致急性肝衰竭（ALF）的病例。患者临床上表现为典型的ALF。肝脏超声报告肝脏肿大，门静脉血流呈搏动性，肝静脉扩张。经胸超声心动图显示主动脉根部局灶性瘤样扩张，有血流穿过瘤体进入右心房，右心腔压力升高。非冠状动脉SOVA的手术修复成功，术后肝转氨酶改善，ALF得到缓解。鉴于破裂的SOVA可以通过手术修复，肝病学家应该意识到在患有ALF的年轻患者中存在这种诊断。
