[A study on the ruptured Valsalva sinus aneurysm using two-dimensional echocardiography].

We visualized the Valsalva sinus aneurysm ruptured into the right ventricle using two-dimensional echocardiography, and analyzed the blood flow by pulsed Doppler technic. Cross-sectional echocardiography was performed on 11 patients with right sinus aneurysm protruding into the right ventricle. The age of the examined subjects ranged from 17 to 40 years. Ten of the 11 revealed a ruptured aneurysm of the right sinus of Valsalva into the right ventricle. Nine of the 11 had ventricular septal defect and five were associated with aortic regurgitation. Pulmonic regurgitation was recognized in one case. The diagnosis was made by cardiac catheterization and angio-cardiography in all cases and was confirmed by cardiac surgery in nine patients. In this study, we employed an electronic (SSH-11A) or mechanical sector scanning system (SSL-51H) for cross-sectional echocardiography. In order to clearly visualize an aneurysm, the cross-section of the left ventricular long-axis was obtained from a slightly lower and more sagittal position than the standard method. In addition, the short axis cross-section of the aortic root was also examined. Furthermore, a pulsed Doppler technic was applied to three patients using a Doppler unit SDS-10A combined with SSH-11A. In all patients, an aneurysm of the right sinus of Valsalva was seen to protrude into the right ventricle by two-dimensional echocardiography. Furthermore, the ruptured orifice of the aneurysm was clearly visualized in ten cases. The shape of the aneurysm was tubular in ten cases and saccular in the remaining one. A continuous blood flow of wide band pattern was recorded in the right ventricle near the ruptured orifice in two of the examined three cases and a disturbed diastolic flow was noted in a saccular aneurysm. In conclusion, two-dimensional echocardiography is useful to visualize an aneurysm of the right sinus of Valsalva ruptured into the right ventricle and a pulsed Doppler technic is greatly contributed in detecting localized disturbed flow due to the ruptured aneurysm.