A Sinus of Valsalva - Right Atrium Fistula without Aneurysm Formation

• Published in: Internal Medicine Vol. 49; no. 8; pp. 749 - 751
• Main Authors: Kanzaki, Yumiko, Terasaki, Fumio, Fuji, Shigeo, Kashiyama, Tomokazu, Kaibe, Shoji, Doi, Yasuji, Kitaura, Yasushi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2010
• Subjects: Aortic Aneurysm - diagnostic imaging; congestive heart failure; echocardiography; Echocardiography, Transesophageal; fistula; Heart Atria - abnormalities; Heart Atria - diagnostic imaging; Humans; Male; Middle Aged; sinus of Valsalva; Sinus of Valsalva - abnormalities; Sinus of Valsalva - diagnostic imaging; Vascular Fistula - diagnostic imaging
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.49.3089

A 61-year-old man was admitted to the hospital because of orthopnea and was diagnosed with heart failure with a continuous heart murmur. A transthoracic echocardiogram revealed turbulent flow from the right coronary sinus of Valsalva to the right atrium throughout the cardiac cycle. Aortography confirmed the presence of a shunt jet from the right coronary sinus of Valsalva to the right atrium. Cardiac catheterization revealed a left-right shunt rate of 47% and a pulmonary to systemic blood flow ratio of 1.81. Transesophageal echocardiography confirmed the existence of the shunt jet and revealed no deformity of the sinus of Valsalva. We report a rare case of sinus of Valsalva-right atrium fistula without typical aneurysmal formation.