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Aneurysms of the aortic sinus of Valsalva. A review of the clinical, radiological and pathological features.

Summary: The clinical features of ten cases with ruptured aortic sinus aneurysms are reviewed. The ages of the patients ranged from two months to 44 years. The main presenting symptoms were those of acute cardiac failure. The finding of a “continuous” murmur over a wide area of the praecordium suggested the diagnosis in all except the young infant who had a patent ductus arteriosus as well. Right heart catheterisation followed by left ventricular angiography and aortic root aortographywere reliable means of confirming the diagnosis as well as recognising any associated lesions such as aortic insufficiency and ventricular septal defect. In all ten cases the aneurysm was in the right aortic sinus and except for one had ruptured into the right ventricle. The period of survival after rupture occurred varied, one patient died after about 24 hours whilst one was still alive 10 years later. Recognition of patients with this lesion is important because restoration to good health can be achieved by successful surgery.