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Re: sinus of valsalva aneurysm

Posted By CCF CARDIO MD - MTR on July 30, 1998 at 16:35:56:

In Reply to: sinus of valsalva aneurysm posted by jerry maxham on July 30, 1998 at 09:13:20:

41 y/o with US results: a congenital aneurysm with dimension of at least 20mm length and .7cm width that appears to originate from the right coronary sinus of Valsalva. Typical windsock appearance, pointing towards the right ventricle underneath the septal leaflet of the tricuspid valve. No evidence of left to right shunt. Mitral valve normal, no mitral regurgitation. Aortic valve showed mild degree of regurgitation. Aortic root not dilated. Tricuspid valve looks normal. Ejection fraction probably in range of 60%. I have been told this is rare and few have experience with same. Can you recommend cardiologist/cardiac surgeon with such experience? And does CC offer MRA? Thanks.

Dear Jerry, thank you for your question.  You are correct that a sinus of Valsalva
aneurysm is a rare condition, but fortunately we have a number of cardiologists
and cardiac surgeons here at Cleveland Clinic who are experienced with this
disorder.  You have the most common type of aneurysm arising from the right
coronary cusp which is seen in 69% of cases.  There are no specific data
indicating the risk of rupture for a sinus of Valsalva aneurysm nor what the
success rates of repair of the aneurysm vs. aortic valve replacement are.  It appears
in your case that the aortic valve may be involved since you have a mild amount
of aortic valve regurgitation.  Thus, consideration would have to been given to
how to preserve or fix the aortic valve at the same time as repairing the
aneurysm.  We have all the capabilities necessary for such an evaluation here at the
Cleveland Clinic including MRI, MRA, and transesophageal echocardiography
to determine what the best approach to your problem is.  We would happy to
evaluate you here at the Cleveland Clinic.  To initiate that process, I suggest
you call Cathy who is a surgical physician's assistant at 1-800-CCF-CARE and
ask for her to be paged at #24774.   It would be very important for you to
bring detailed medical records with you for an evaluation here including copies
of echo tapes, cardiac catheterization films (if that test was done), and any
radiographic studies that have been done.  If you are unable to come to our
institution, Cathy may be able to help you find a cardiologist/surgeon closer
to you who has some experience in this area.  I hope you find this information
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.  

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