Unruptured Sinus of Valsalva Aneurysm, With Dissection into the Interventricular Septum

Abstract

Sinuses of Valsalva or aortic sinuses are 3 focal expansions at the root of the aorta and are named right, left and non-coronary sinuses. These sinuses serve as support system for the aortic valve and prevent occlusion of the coronary ostia as the aortic cusps open in systole. Sinus of Valsalva aneurysm (SOVA) is congenital in most cases, due to deficiency of the elastic lamina between the aortic media and the annulus fibrosus. The anatomical location of these sinuses can predict some clinical consequences, when complications occur. We report the case of a 29yr old Nigerian man who presented at the accident and emergency unit of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, with clinical features of heart failure. Electrocardiography showed complete heart block, and later supraventricular tachycardia, while echocardiography showed a right sinus of valsalva aneurysm dissecting into the interventricular septum, without evidence of rupture.