Resolution of post-anaesthesia aortic regurgitation by repair of a ruptured sinus of Valsalva aneurysm: 5 case reports
- PDF / 873,524 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 84 Downloads / 156 Views
Open Access
CASE REPORT
Resolution of post‑anaesthesia aortic regurgitation by repair of a ruptured sinus of Valsalva aneurysm: 5 case reports Qian Xue, Chun Yang* and Xiu Han
Abstract Background: Ruptured sinus of Valsalva aneurysm (SVA) is a rare cardiovascular disease in which some patients exhibit aortic valve insufficiency. SVA repair and valve replacement are usually required for treatment. Here, we report 5 cases of ruptured SVA with severe post-anaesthesia aortic regurgitation (AR). To the best of our knowledge, this is the first report of ruptured SVA with severe post-anaesthesia AR. Case presentation: From 2018 to 2020, there were 5 cases of ruptured SVA with severe AR after anaesthesia in our hospital. The main symptoms were palpitation and shortness of breath. Transthoracic echocardiography (TTE) with colour-flow Doppler showed ruptured aortic sinus aneurysms without AR. Post-anaesthesia echocardiography showed severe AR. Direct patch closure of the ruptured aneurysm resolved the left-to-right shunt and AR, and the aortic valve was not replaced. Conclusions: Post-anaesthesia AR without obvious structural defects may occur in patients with ruptured SVAs. Valve replacement may not be necessary. Keywords: Post-anaesthesia aortic regurgitation, Ruptured sinus of Valsalva aneurysm, TEE Background Sinus of Valsalva aneurysm (SVA) is a rare cardiovascular disease. In 1839, Hope gave the first report of a ruptured SVA, which occurred in a 25-year-old patient [1]. SVA occurs most frequently in the right sinus of Valsalva, followed by the noncoronary sinus; the least frequent location is the left coronary sinus [2]. The present study includes 5 patients with ruptured SVAs who experienced severe aortic regurgitation (AR) after anaesthesia. Simple patch closure of the ruptured aneurysm solved the leftto-right shunt and the AR. We discuss the causes of this phenomenon and propose that, for this type of patient, the surgeon needs to decide whether it is necessary to replace the aortic valve to eliminate aortic regurgitation *Correspondence: [email protected] Department of Cardiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China
based on the results of pre-anaesthesia echocardiography and an evaluation of the aortic valve structure.
Case presentation From 2018 to 2020, there were 5 cases of ruptured SVA with severe post-anaesthesia AR in our hospital. The 5 included patients ranged from 25 to 42 years of age, and all of them were male. Three of them had a history of hypertension. The time from onset to treatment varied from 7 to 45 days. The patients came to the hospital for treatment due to palpitations and shortness of breath. No treatment was given before admission. Cardiac auscultation revealed the presence of systolic and diastolic murmurs. Transthoracic echocardiography (TTE) with colour-flow Doppler showed ruptured aortic sinus aneurysms without AR. Four patients had a noncoronary sinus that had ruptured into the right atrium, and
© The Author(s) 2020. This article
Data Loading...
