Left coronary sinus of Valsalva aneurysm ruptured into the left ventricle – Case report Ajit Desai, Nihar Mehta, Vivek Mandurke, Sanjeev Vichare, Anmol.

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Left coronary sinus of Valsalva aneurysm ruptured into the left ventricle – Case report Ajit Desai, Nihar Mehta, Vivek Mandurke, Sanjeev Vichare, Anmol Sonawane Journal of Indian College of Cardiology Volume 3, Issue 1, Pages 32-36 (March 2013) DOI: 10.1016/j.jicc.2012.12.005 Copyright © 2013 Terms and Conditions

Fig. 1 Preoperative 2D echo showing parasternal short axis view of sinus of Valsalva aneurysm arising from the left coronary cusp. A flap is also seen at the mouth of the aneurysm. On the right, color Doppler shows turbulent flow from the aorta into the aneurysm and tracking into the left ventricle. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 2 Preoperative 2D echo showing a parasternal short axis view of the left ventricle with the sinus of Valsalva aneurysm opening just below the level of the mitral valve. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 3 Preoperative 2D echo showing apical five chamber view with color Doppler showing severe aortic regurgitation. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 4 CT scan showing the sinus of Valsalva aneurysm arising from the left coronary sinus, extending to the left ventricle. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 5 Intraoperative picture showing the orifice of the sinus of Valsalva aneurysm arising from the left coronary sinus (arrow). The origin of the left coronary artery can be seen (arrow head). Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 6 Intraoperative picture showing the dacron patch used for closing the opening in the left ventricular (arrow) and the dacron patch used for the closing the opening in the left sinus of Valsalva (arrow head). Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 7 Post operative 2D echo showing parasternal short axis view of the prosthetic aortic valve with the thrombosed aneurysmal sac laterally. A dacron patch was used to seal the opening. On the right, color Doppler shows no flow demonstrated across the aneurysm. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions

Fig. 8 Post operative 2D echo showing parasternal short axis view of the thrombosed aneurysmal sac extending to the left ventricle near the junction of the IVS and posterolateral wall. A dacron patch was used to seal the opening. Journal of Indian College of Cardiology 2013 3, 32-36DOI: (10.1016/j.jicc.2012.12.005) Copyright © 2013 Terms and Conditions