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american research journal of cardiovascular .pdf

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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

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


Ruptured sinus of Valsalva aneurysm with
vegetation in right atrium is a rare disorder.
Prompt diagnosis and surgical intervention
gives good result.

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.

Fig 1. x-ray chest- huge cardiomegally

Page 3 Fig2. Huge
right atrial and right
ventricular enlargement

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

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

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