CTICasesSinus of Valsalva Aneurysm with Bicuspid Aortic Valve and Coarctation of the Aorta
Imaging findings
CT and angiographic imaging demonstrate a very large sinus of Valsalva aneurysm arising from the left coronary sinus, communicating directly with the ascending aorta. This aneurysm causes significant mass effect, dramatically displacing and severely compressing the proximal left anterior descending coronary artery. Real-time ventricular angiography confirms slow filling of the aneurysm. Additional findings include a bicuspid aortic valve and a mild coarctation of the aorta.
Key takeaways
Sinus of Valsalva aneurysms are rare congenital anomalies, and those arising from the left coronary sinus are the least common. Unlike aneurysms of the right or non-coronary sinuses, which typically rupture or decompress into the right heart chambers, left-sided aneurysms are particularly prone to compressing adjacent coronary arteries, potentially causing myocardial ischemia or acute myocardial infarction. Bicuspid aortic valve and aortic coarctation are well-known congenital associations.
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