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Giant Aneurysm of Left Coronary Artery Associated With Aneurysm of Right Sinus of Valsalva
Giant Aneurysm of Left Coronary Artery Associated With Aneurysm of Right Sinus of Valsalva Humberto Morais, MD, and Valdano Manuel, MD Cardiology Department, Hospital Militar Principal/Instituto Superior, Luanda; and Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola
Fig 1.
A
9-year-old girl with history of sickle cell disease presented to our hospital due the complains of chest pain, fatigue, and palpitations. The transthoracic echocardiogram showed an aneurysm of right sinus of Valsalva dissecting into the interventricular septum. The echocardiogram also showed a “cystic mass” suggesting another aneurysm around the descending coronary artery. The left ventricle was slightly dilated with septoapical dyskinesia; the ejection fraction was 53%. For better evaluation, computed tomographic angiography was performed in which the diagnosis of aneurysm of right sinus of Valsalva (Fig 1A; blue arrow) dissecting into ventricular septum (Fig 1B; blue arrow) and a giant
aneurysm arising from the left coronary artery (Fig 1C; white arrow) was established. The patient was refused for surgery due the high surgical risks. The patient was lost to follow-up. Aneurysm of sinus of Valsalva as well as the aneurysm of left coronary artery are rare cardiac anomalies. The association of theses condition in the same patient is extremely rare [1]. The present case in addition to be in a pediatric patient without evidence suggesting that the condition was acquired, the patient also had sickle cell disease.
Reference Address correspondence to Dr Morais, Cardiology Department, Hospital Militar Principal/Instituto Superior, Luanda, Angola; email: hmorais1@ gmail.com.
Ó 2016 by The Society of Thoracic Surgeons Published by Elsevier
1. Okinaka T, Isaka N, Nakano T. Coexistence of giant aneurysm of sinus of Valsalva and coronary artery aneurysm associated with idiopathic hypereosinophilic syndrome. Heart 2000;84:e7.
Ann Thorac Surg 2016;102:e569 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2016.05.067
Fig 1.
A
9-year-old girl with history of sickle cell disease presented to our hospital due the complains of chest pain, fatigue, and palpitations. The transthoracic echocardiogram showed an aneurysm of right sinus of Valsalva dissecting into the interventricular septum. The echocardiogram also showed a “cystic mass” suggesting another aneurysm around the descending coronary artery. The left ventricle was slightly dilated with septoapical dyskinesia; the ejection fraction was 53%. For better evaluation, computed tomographic angiography was performed in which the diagnosis of aneurysm of right sinus of Valsalva (Fig 1A; blue arrow) dissecting into ventricular septum (Fig 1B; blue arrow) and a giant
aneurysm arising from the left coronary artery (Fig 1C; white arrow) was established. The patient was refused for surgery due the high surgical risks. The patient was lost to follow-up. Aneurysm of sinus of Valsalva as well as the aneurysm of left coronary artery are rare cardiac anomalies. The association of theses condition in the same patient is extremely rare [1]. The present case in addition to be in a pediatric patient without evidence suggesting that the condition was acquired, the patient also had sickle cell disease.
Reference Address correspondence to Dr Morais, Cardiology Department, Hospital Militar Principal/Instituto Superior, Luanda, Angola; email: hmorais1@ gmail.com.
Ó 2016 by The Society of Thoracic Surgeons Published by Elsevier
1. Okinaka T, Isaka N, Nakano T. Coexistence of giant aneurysm of sinus of Valsalva and coronary artery aneurysm associated with idiopathic hypereosinophilic syndrome. Heart 2000;84:e7.
Ann Thorac Surg 2016;102:e569 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2016.05.067