DOPPLER-ECHOCARDIOGRAPHIC CHARACTERISTICS OF SINUS OF VALSALVA ANEURYSMS

An aneurysm of the sinus of Valsalva (SVA) is a relatively rare congenital anomaly accounting for less than 1% of operative cases requiring cardiopulmonary bypass for congenital heart disease.(1) It may be clinically silent for many years, causing symptoms only when mechanical obstruction or rupture occurs, and it appears to be more common in Orientals and in men.(2-4) The hemodynamic consequences of rupture may lead to rapidly progressive heart failure; thus rapid and accurate diagnosis is essential. The essential anatomic defect is a failure of fusion between the aortic media and the heart at the level of the annulus fibrosis of the aortic valve.(5) This failure allows weakening of the SVA wall and eventual development of an aneurysm. Doppler echocardiography has greatly enhanced the capability for diagnosis of an SVA and its associated lesions. The current spatial resolution of echocardiography and color flow mapping has the potential for detailed anatomic analysis of SVA and its associated defects similar to previous necropsy series.(5, 6) This study evaluates the efficacy of Doppler echocardiography for detailed anatomic analysis of a consecutive series of patients with SVA, all of whom had surgical confirmation of the anatomic abnormality.