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A Traumatic Rupture of Valsalva Sinus With Dissection Into the Interventricular Septum
Journal of the American College of Cardiology © 2011 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 57, No. 23, 2011 ISSN 0735-1097/$36.00 doi:10.1016/j.jacc.2010.08.654
IMAGES IN CARDIOLOGY
A Traumatic Rupture of Valsalva Sinus With Dissection Into the Interventricular Septum Lili Dong, MD, Cuizhen Pan, MD, Weipeng Zhao, MD, Xianhong Shu, MD Shanghai, China
From the Department of Echocardiography, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China. Manuscript received August 11, 2010; accepted August 25, 2010.
A
57-year-old man with no medical history was involved in an accidental fall from a height with chest pain and rapid deceleration. No injury was apparent initially, but 1 year later, he developed exertional dyspnea and was referred to our institute for assessment. A transthoracic echocardiogram demonstrated the rupture (A, arrow, Online Video 1) of the right Valsalva sinus with dissection into the interventricular septum (IVS) and formation of a false cavity (A, asterisk, Online Video 1), and the orifice (A, triangle, Online Video 1) of septal dissection leading into the left ventricle (LV) during diastole. The false cavity (B, asterisk, Online Video 1) within the septum became smaller during systole. Doppler echocardiography showed diastolic regurgitation (C, arrow) from the aortic root into the false cavity within the septum, which finally flowed into the LV (C, triangle). Surgery was performed later, and the aforementioned morphology was confirmed. Photography obtained at surgery showed the rupture site (D, arrow) of the right Valsalva sinus and the orifice (D, triangle) of septal dissection leading into the LV. AO ⫽ aorta; LA ⫽ left atrium; LCV ⫽ left coronary valve; NCV ⫽ noncoronary valve; RCV ⫽ right coronary valve; RV ⫽ right ventricle.
Vol. 57, No. 23, 2011 ISSN 0735-1097/$36.00 doi:10.1016/j.jacc.2010.08.654
IMAGES IN CARDIOLOGY
A Traumatic Rupture of Valsalva Sinus With Dissection Into the Interventricular Septum Lili Dong, MD, Cuizhen Pan, MD, Weipeng Zhao, MD, Xianhong Shu, MD Shanghai, China
From the Department of Echocardiography, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China. Manuscript received August 11, 2010; accepted August 25, 2010.
A
57-year-old man with no medical history was involved in an accidental fall from a height with chest pain and rapid deceleration. No injury was apparent initially, but 1 year later, he developed exertional dyspnea and was referred to our institute for assessment. A transthoracic echocardiogram demonstrated the rupture (A, arrow, Online Video 1) of the right Valsalva sinus with dissection into the interventricular septum (IVS) and formation of a false cavity (A, asterisk, Online Video 1), and the orifice (A, triangle, Online Video 1) of septal dissection leading into the left ventricle (LV) during diastole. The false cavity (B, asterisk, Online Video 1) within the septum became smaller during systole. Doppler echocardiography showed diastolic regurgitation (C, arrow) from the aortic root into the false cavity within the septum, which finally flowed into the LV (C, triangle). Surgery was performed later, and the aforementioned morphology was confirmed. Photography obtained at surgery showed the rupture site (D, arrow) of the right Valsalva sinus and the orifice (D, triangle) of septal dissection leading into the LV. AO ⫽ aorta; LA ⫽ left atrium; LCV ⫽ left coronary valve; NCV ⫽ noncoronary valve; RCV ⫽ right coronary valve; RV ⫽ right ventricle.