Aneurysm of the aortic sinus, also known as the sinus of Valsalva. This aneurysm is comparatively rare, occurring in about one person in every thousand. When present, it is usually in either the right (65-85%) or in the noncoronary (10-30%) sinus, rarely in the left (< 5%) sinus. This type aneurysm is typically congenital and may be associated with cardic defects. It is sometimes associated with Marfan syndrome, but may also result from atherosclerosis, syphilis, cystic medial necrosis, chest injury, or infective endocarditis.
If unruptured, this type aneurysm may be aymptomatic and therefore go undetected until symptoms appear or medical imaging is perfomed for other reasons.
Treatment
Medical therapy of aneurysm of the aortic sinus includes blood pressure control through the use of drugs, such as beta blockers. The definitive treatment is surgical repair. The determination to perform surgery is usually based upon the diameter of the aortic root and the rate of increase in its size, as determined through repeated echocardiography.
Acquired aneurysmal dilatation of the sinuses of Valsalva may occur because of Marfan Syndrome, syphilitic aortitis, or as a function of aging.
Sinus of Valsalvaaneurysm is associated with a ventricular septal defect in approximately 40% of patients.
Aneurysms most often involve the right aortic sinus (67-85% of patients, often associated with a supracristal ventricular septal defect), followed by the noncoronary sinus, while an aneurysm of the left sinus is rare.
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