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2. A Case Report Ruptured Sinus of
Valsalva Aneurysm With
Vegetation in Right Atrium
*NM Zahangir, 2S T Ahmed, 3F Ahmed, 4M M Kabir, 5N Hossain, 6A Khan, 7N Ahmed,
8M N Janardhan

3. Department of Cardiovascular and thoracic
Surgery, Apollo Hospitals, Dhaka, Bangladesh
*Associate Consultant, Cardiovascular and
thoracic Surgery, 2Registrar, Cardiovascular
and thoracic Surgery, 3Registrar,
Cardiovascular and thoracic Surgery,
5Specialist, Cardiothoracic Anesthesia
6Senior Medical Officer, Cardiovascular and
thoracic Surgery, 7consultant, Cardiothoracic
Anesthesia, 8Senior Consultant, Cardiovascular
and thoracic Surgery
nmzaha@yahoo.com

4. Abstract
Background
Ruptured sinus of Valsalva aneurysm with
moderate aortoic regurgitation with
vegetation in right atrium is a rare disorder.
Prompt diagnosis and surgical intervention
gives good result.

5. Methods
33 years old gentleman came to our hospital with ruptured non-coronary
sinus of valsalva into right atrium. Operation was done on 15.11.12. Non
coronary sinus was hugely dilated with a perforation at apex . Double ended
pledgeted horizontal mattress suture was applied to aneurismal area around
the perforation in normal healthy tissue. Right atrium was opened , about 4cm
long vegetation was found, it was excised .Double ended pledgeted horizontal
mattress suture was applied around the perforation site in Right atrium. PTFE
patch closure of aneurismal part of Non coronary sinus of aorta was
done,sutures were passed through normal healthy sinus tissue. Now aortic
cusp coaptation was checked by saline test –found good coaptation. Cross
clamp was removed .Weaning from CPB was done uneventfully .TEE was done
after weaning from CPB—no leakage was found through the patch are and no
aortic regurgitation was present.

6. Fig 1. x-ray chest- huge cardiomegally

7. Page 3 Fig2. Huge
right atrial and right
ventricular enlargement

8. Fig 3. Non coronary
sinus is hugely dilated
with a perforation in
apex

9. Fig 4. Double ended
pledgeted horizontal
mattress suture was
applied to aneurysmal
area around the
perforation

10. Fig 5. Right atrium was
opened ,about 4cm long
vegetation was found,
was attached to the
connecting site of Non
coronary aneurysmal
sinus

11. A Case Report
Ruptured Sinus of
Valsalva Aneurysm
With Vegetation in
Right Atrium

12. Fig 7. Double ended
pledgeted horizontal
mattress suture was
applied around the
perforation site in Right

13. Fig 8. PTFE patch
closure of aneurismal
part of Non coronary
sinus

14. Fig 9. PTFE patch
closure of aneurismal
part of Non coronary
sinus

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