CTICasesGiant Sinus of Valsalva Aneurysm
Imaging findings
Contrast-enhanced chest CT shows a persistent left superior vena cava (SVC) and a giant, unruptured sinus of Valsalva aneurysm arising from the right coronary cusp. The aneurysm is extremely large and prolapses directly into the right ventricular outflow tract (RVOT), causing right ventricular outflow tract obstruction, right ventricular dilatation, and right ventricular hypertrophy.
Key takeaways
Sinus of Valsalva aneurysms most commonly arise from the right coronary sinus. While they typically present after rupture (often into the right ventricle causing acute shunt and high-output heart failure), they can grow to a giant size without rupturing, presenting instead with mechanical right ventricular outflow tract obstruction.
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