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源于巨大非冠状动脉窦瘤的栓塞性卒中：多模态影像学诊断

Embolic Stroke Due to a Large Noncoronary Sinus of Valsalva Aneurysm: A Multimodality Imaging Diagnosis.

作者信息

Miller Tyler C, Wolfe Stanley, Smith Dawn, Bond Jonathan, Havistin Ruby, Mills James D, Moreland Jason, Wei Lawrence, Mehaffey James, Muthukumar Lakshmi

机构信息

Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA.

Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA.

出版信息

JACC Case Rep. 2025 Jun 25;30(16):103761. doi: 10.1016/j.jaccas.2025.103761.

DOI:10.1016/j.jaccas.2025.103761
PMID:40579110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12273851/
Abstract

BACKGROUND

A sinus of Valsalva aneurysm (SoVA) is a rare cardiac condition caused by the dilation of a coronary sinus. If untreated, it can commonly lead to valvular dysfunction, arrhythmias, or rupture.

CASE SUMMARY

A 71-year-old patient with hypertension and hyperlipidemia presented with an embolic stroke. Multimodality imaging revealed a large, 7.0 cm × 5.6 cm SoVA originating from the noncoronary sinus and causing nearly complete obstruction of the left atrium. The aneurysm was surgically repaired, and the patient made a full recovery.

DISCUSSION

In rare cases, a stroke may be the initial presentation of a SoVA. The probable cause of the patient's stroke was attributed to thrombus formation within the SoVA that embolized.

TAKE-HOME MESSAGES: This case emphasizes the importance of multimodality imaging for the diagnosis of a SoVA and for planning surgical repair. Additionally, clinicians should consider a SoVA in the differential diagnosis for a patient presenting with a stroke.

摘要

背景

瓦氏窦瘤（SoVA）是一种由冠状窦扩张引起的罕见心脏疾病。若不治疗，通常会导致瓣膜功能障碍、心律失常或破裂。

病例摘要

一名71岁患有高血压和高脂血症的患者出现栓塞性中风。多模态成像显示一个源自无冠窦的7.0厘米×5.6厘米的大SoVA，几乎完全阻塞左心房。该动脉瘤通过手术修复，患者完全康复。

讨论

在罕见情况下，中风可能是SoVA的首发表现。该患者中风的可能原因归因于SoVA内形成的血栓发生栓塞。

要点

本病例强调了多模态成像对SoVA诊断及手术修复规划的重要性。此外，临床医生在对中风患者进行鉴别诊断时应考虑SoVA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/12481f6a764e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/11a6ed65dd3c/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/53c63b1367f7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/3e9db2372504/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/e87b0b61f5cd/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/5b9271681753/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/890fa70edf17/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/7df3f1220d1b/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/12481f6a764e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/11a6ed65dd3c/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/53c63b1367f7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/3e9db2372504/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/e87b0b61f5cd/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/5b9271681753/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/890fa70edf17/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/7df3f1220d1b/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/742b/12273851/12481f6a764e/gr7.jpg

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