Cover image
Aneurysmal left sinus of Valsalva in Marfan’s syndrome
Mohammed A. Chamsi-Pasha1* and Gerald M. Lawrie2
1Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, SM1901, Houston, Texas 77030, USA; and 2Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, SM1901, Houston, Texas 77030, USA
* Corresponding author. Tel: +713–441–2690, Email: [email protected]
A 42-year-old female with Marfan’s syndrome presented with acute chest pain and shortness of breath. Twenty-one years prior, she underwent ascending aortic repair for type A dissecting aneurysm (DeBakey Type 1) at our institution. Vitals were stable on presentation (blood pressure of 115/57 mmHg, heart rate 86 bpm). Electrocardiogram showed no ischaemic changes and cardiac enzymes were negative. Cardiac computed tomographic angiography showed severe aortic root dilation and aneurysmal left sinus of Valsalva (6.8 cm) (Panels A and B). The aneurysm was causing compression of left main coronary artery at its origin (Panels C and D). Echocardiography showed moderate aortic regurgitation. Patient emergently underwent resection of sinus of Valsalva, replacement of aortic root with valved-conduit and reimplantation of coronary arteries. She had uneventful post-operative course and discharged home. This is a rare presentation of aneurysmal left sinus of Valsalva ‘stretching-out’ left main in a symptomatic Marfan’s patient requiring early surgical intervention.
Panel (A) Sagittal view on cardiac computed tomography (CT) showing severely dilated aortic root and aneurysmal left coronary sinus. Panel (B) Three dimensional-volume rendered image on cardiac CT showing aneurysmal left sinus of Valsalva. Panel (C) Coronal view on cardiac CT showing aortic root dilation along with compression of left main coronary artery origin by the mass-effect from the aneurysm (arrow). Panel (D) Curved planar reformatting of the left anterior descending coronary artery showing severe compression of left main origin (arrow) LCC, left coronary cusp; RCC, right coronary cusp; NCC, non-coronary cusp; LSOV, left sinus of Valsalva.
Volume 39, Issue 4, 21 January 2018
Focus Issue on Imaging
Issue @ A Glance
Frontiers in cardiac imaging: diagnostic and prognostic validity and safety
CardioPulse
Steven Nissen MD
Handheld Echography devices: ready for prime time?
What is CMR doing for patients today?
A new Research Centre in Russia
A new Paediatric Centre in Russia
Current Opinion
Imaging
The year in cardiology 2017: imaging
Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR)
Fast Track Clinical Research
Coronary artery disease
Near-infrared spectroscopy-derived lipid core burden index predicts adverse cardiovascular outcome in patients with coronary artery disease during long-term follow-up
Editorial
An amber signal lights up before the red: do not dismiss it
Clinical Research
Imaging
The effect of 1.5 T cardiac magnetic resonance on human circulating leucocytes
Editorial
Cardiac MR imaging genotoxicity?
Imaging
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy
Editorial
The beginning at the end: non-invasive assessment of post-transplant coronary allograft vasculopathy at the microcirculatory level
