CTICasesContained Rupture of Sinus of Valsalva Abscess
Imaging findings
CT in a patient with a history of endocarditis and a bicuspid aortic valve shows a blowout of the sinus of Valsalva wall with a paravalvular abscess/contained rupture fistulizing both above and below the aortic valve plane, causing acute aortic regurgitation.
Key takeaways
Paravalvular abscess and contained aortic root rupture are serious complications of infective endocarditis, particularly in bicuspid aortic valves. CT angiography is highly sensitive for demonstrating the extent of tissue infiltration and fistulization which can be missed or underestimated on echocardiography.
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