CTICasesSinus of Valsalva Aneurysm
Imaging findings
Contrast-enhanced chest CT demonstrates a large, saccular aneurysm arising from the right coronary sinus of Valsalva, projecting anteriorly. Prior sternotomy wires are present from CABG. Reformatted images suggest a small, residual or sealed supracristal ventricular septal defect (VSD) situated immediately adjacent to the right coronary sinus.
Key takeaways
Sinus of Valsalva aneurysms are rare cardiovascular anomalies that can be congenital or acquired. Congenital aneurysms typically affect the right coronary sinus (followed by the non-coronary sinus) and are strongly associated with ventricular septal defects, particularly supracristal VSDs. The high-velocity shunt jet from the VSD causes a 'windsock' effect on the aortic wall, leading to progressive dilatation and risk of rupture into the right heart chambers.
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