Ruptured Aneurysm of the Sinus of Valsalva into the Right Atrium without Ventricular Septal Defect: A Case Report and Literature Review

無伴隨心室中隔缺損的主動脈竇動脈瘤破裂到右心房：病例報告及文獻回顧

李碩粲(Shuo-Tsan Lee) ； 林宗憲(Tsung-Hsien Lin) ； 蘇河名(Ho-Ming Su) ； 邱肇基(Chaw-Chi Chiu) ； 溫文才(Wen-Chol Voon) ； 賴文德(Wen-Ter Lai) ； 許勝雄(Sheng-Hsiung Sheu) ； 林永哲(Young-Tso Lin)

《The Kaohsiung Journal of Medical Sciences》 21卷12期 (2005/12) Pp. 517-521

摘要

主動脈竇動脈瘤通常伴隨心室中隔缺損。其可能為先天或後天得到的罕見心臟病。主動脈竇動脈瘤少發生在非冠狀動脈竇。一旦主動脈竇動脈瘤破裂通常會產生嚴重的血行動力學變化。若不開刀治療通常預後不良。我們報導一位55歲女性病人，其主述為活動時有氣促情形。胸前超音波與主動脈攝影顯示主動脈竇動脈瘤在非冠狀動脈竇，無伴隨心室中隔缺損且動脈瘤破裂到右心房。由於有大量的左到右分流，病人接受手術治療將主動脈竇動脈瘤破裂修補。這個病例呈現一位少見非冠狀動脈竇的主動脈竇動脈瘤破裂到右心房且無伴隨心室中隔缺損。

關鍵字

動脈瘤 ； 主動脈竇 ； 破裂 ； 右心房 ； 非冠狀動脈竇

並列摘要

Aneurysm of the sinus of Valsalva (ASV), frequently associated with ventricular septal defect (VSD), is a rare cardiac disease that may be acquired or congenital. Rupture of an ASV, rare in the noncoronary cusp, usually produces serious hemodynamic change and carries poor prognosis if not treated surgically. We present the case of a 55-year-old female who came to us complaining of exertional dyspnea. Transthoracic echocardiography and aortography showed a noncoronary cusp ASV with rupture into the right atrium but without VSD. Because of high left to right shunt flow, she underwent successful surgical intervention with aneurysm repair approached from both the aorta and right atrium with a knitted Dacron patch. This was a rare case of noncoronary cusp involvement in ASV that ruptured into the right atrium without VSD.

並列關鍵字

aneurysm ； sinus of Valsalva ； rupture ； right atrium ； noncoronary cusp