Sinus of Valsalva Aneurysm Repair

From the desk of Dr. Grayson Wheatley

"An Aneurysm of a Different Sort"

Nashville, Tennessee - Most aortic aneurysms involve a localized bulge, or swelling, of the aorta.  There are several types of aortic aneurysms, such as saccular aortic aneurysms, fusiform aortic aneurysms and even something called pseudaneurysms.

There is a rare type of aneurysm that involves the aortic root (section of aorta right above the aortic valve) that bulges into the heart.

A sinus of valsalva aneurysm is a discrete, localized "dimple" of the spot in the aortic root which expands into either the right atrium or right ventricle.

Most of these types of aneurysms arise from defect in the aorta from birth.

Request a consultation with Dr. Wheatley: 1-615-342-6900

most insurance plans accepted

These types of aortic aneurysms are quite rare and not quite as dangerous as other types because if they do swell to the point that they burst, or rupture, they rupture into the heart itself.

The difference here, is that when an aneurysm expands to the point that it gives way, or ruptures (bursts), it causes internal bleeding that can cause patients to die quickly.

In the case of a sinus of valsalva aneurysm, with it swelling into the actually chambers of the heart, when it ruptures the internal bleeding stays within the heart itself and doesn't lead to instant blood loss.

Instead, a new communication is created inside the heart, called a fistula, which can cause the heart to develop congestive heart failure due to an increased amount of blood inside the chambers of the heart along with increased strain on the heart muscle.

Dr. Grayson Wheatley is a Heart and Vascular Surgeon and Director of Aortic and Endovascular Surgery at TriStar Centennial Medical Center in Nashville, TN

Send Dr. Wheatley a message and he will follow-up with you directly.

Cardiac Echocardiogram of a sinus of valsalva aneurysm originating off the right sinus of valsalva and protruding into the right ventricle

Surgical repair of sinus of valsalva aneurysm using a pericardial patch just above the aortic valve using open heart surgery

Most patients with a sinus of valsalva aneurysm do not have any symptoms until it ruptures into the heart.  Patients then experience shortness of breath, decreased capacity for activities, chest pressure and sometimes palpitations.

A sinus of valsalva aneurysm can be identified or detected as part of a workup for new heart problems or even as part of a standard heart checkup.  Usually, an cardiac echocardiogram (sonogram / ultrasound) of the heart can identify the problem along with CT scans and MRIs.

Treatment of sinus of valsalva aneurysms involves open heart surgery.  The heart needs to be stopped while a heart-lung machine does the work of the heart and lungs.  The opening - or dimple - in the aortic root where the sinus of valsalva aneurysm originates is patched with a piece of tissue which seals off the swelling.  (Like a cork in a bottle).  If the aneurysm has ruptured into a chamber of the heart, the site of the rupture needs to also be removed by opening either the right atrium or right ventricle.

The Aortic Center at Centennial Medical Center is pre-eminently qualified and skilled at treating patients with all forms of open aortic surgery and procedures (chest and abdomen) and is prepared to care for all patients with aortic aneurysms, aortic dissections, aortic valve disorders, and other types of aortic diseases including aortic transections, aortic pseudoaneurysms and penetrating aortic ulcers.

Contact us today to request your consultation at 1-615-342-6900 or email us at info@badaorta.com and we will evaluate your unique aortic problem and provide a customized approach to your specific aortic problem.