A 51-year-old man was presented to the hospital with chest discomfort
and shortness of breath. Chest X-ray
showed local calcification and uplift at the left margin of the heart
(Figure1, arrow). The transthoracic echocardiography demonstrated that
the huge mass was originating from the aortic left coronary sinus and
moderate aortic valve regurgitation (Figure2, asterisk). Cardiac
computed tomographic angiography showed aneurysmal left sinus of
Valsalva (9.2*7.7cm) and mild aortic valve deformation. The aneurysm was
causing compression of left atrial and left pulmonary vein
(Figure3 A, B, asterisk).
Three-dimensional reconstruction
images on cardiac CT showing aneurysmal left sinus of Valsalva and the
left coronary artery arises from the aneurysm (Figure3C, asterisk).
Patient underwent resection of sinus of Valsalva, a reconstruction of
left-coronary Valsalva sinus with a prosthetic patch reimplantation of
the left coronary to the aorta and a folding of the aneurysmal (Figure4
A, B, arrow). The patient recovered uneventfully and discharged ten days
later. On follow-up examination revealed remarkable reduction of the
volume of aneurysmal left of Valsalva and the left coronary artery
functions normally (Figure4 C).
Figure
1. Chest x-ray showing the
aneurysm(arrow).
Figure 2. Echocardiogram revealed
the Aneurysmal of the left sinus of Valsalva(asterisk).
Figure 3. The chest computed tomography showing the aneurysm (A, B)
cross-sectional (arrow) (C) Three-dimensional reconstruction (arrow).
Figure 4. Intra-operative image
(A, B, arrow) showing the aneurysm and postoperative image (C) showing
the left coronary artery(arrow).