A Giant Left Coronary Sinus of Valsalva Aneurysm After Type A Aortic Dissection María Martín, MD, PhD, Rub en Alvarez-Cabo, MD, Manuel Barreiro, MD, Cecilia Corros, MD, Ana García Campos, MD, María Luisa Rodríguez, MD, PhD, Jes us M. de la Hera, MD, Luis H. Luyando, MD, PhD, and C esar Morís, MD, PhD Departments of Cardiology, Cardiac Surgery, and Radiology, Hospital Central de Asturias, Oviedo, Spain

FEATURE ARTICLES Fig 1.

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59-year-old woman with Marfan syndrome was referred for cardiac computed tomography with echocardiographic diagnosis of sinus of Valsalva aneurysm. Twenty years earlier, she had had an aortic type A dissection. A mechanical prosthesis and a 30-mm supracoronary graft were implanted. The right coronary artery was reimplanted. Cardiac computed tomography showed a 10  7.8 cm aneurysm arising from the left sinus of Valsalva (Fig 1; note the descending aortic dissection [arrow] and the previous reimplantation of the right coronary artery [arrow]). Reintervention preserved the mechanical prosthesis, and the aortic root was replaced.

Address correspondence to Dr Martín, Avda Julian Clavería s/n 33007, Oviedo, Asturias, Spain; e-mail: [email protected].

Ó 2014 by The Society of Thoracic Surgeons Published by Elsevier Inc

Coronary arteries were reimplanted following Cabrol’s technique. Most sinus of Valsalva aneurysms are congenital. Acquired aneurysms are caused by conditions affecting the aortic wall, such as infection, degenerative disease, or thoracic trauma [1]. In our case, although Marfan syndrome was the main condition, prior replacement of the supracoronary aorta alone can also be followed by recurrent aneurysm formation at the level of the residual aortic root. As regards diagnostic tools, echocardiography and cardiac computed tomography are complementary.

Reference 1. Sen T, Guray Y, Hajro E, Demirkan BM. Giant unruptured noncoronary sinus of Valsalva aneurysm with ascending aorta dissection. Eur J Cardiothorac Surg 2009;36:187. Ann Thorac Surg 2014;97:1082  0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2013.07.114

A giant left coronary sinus of valsalva aneurysm after type A aortic dissection.

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