CTICasesRuptured Sinus of Valsalva Aneurysm with Anomalous Septal Course of Left Main Coronary Artery
▶ Watch on YouTube — age-restricted, cannot embed here
[...]. Ruptured Sinus of Valsalva Aneurysm with Anomalous Septal Course of Left Main Coronary Artery. CTICases. Published September 20, 2014. https://str-case-explorer.pages.dev/c/gd2b8
Imaging findings
CT shows an abnormal outpouching from the non-coronary sinus extending into the right atrium, consistent with a ruptured Sinus of Valsalva aneurysm. Cine sequences demonstrate two jets of shunting blood: one posteriorly towards the right atrium (throughout cardiac cycle) and another anteriorly (pronounced during diastole due to RV pressure release). Additionally, the left main coronary artery has an anomalous septal course, originating from the right coronary cusp, coursing into the septum, giving off a large septal branch, and then exiting to supply the circumflex and a "second LAD" territory. MRI confirms the two shunting jets.
Key takeaways
Sinus of Valsalva aneurysms are often congenital and can rupture into the right atrium, leading to heart failure. The presence of two shunting jets with different flow dynamics depending on cardiac cycle phase is notable. Concurrent anomalous coronary anatomy, specifically a septal course of the left main, is a rare additional finding.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Neurofibromatosis with Ruptured Intercostal Artery AneurysmsCongenital
- Massive Ascending Aortic Aneurysm due to Healed Non-specific VasculitisAorta & Arteries
- Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) with Carcinoid TumorsNeoplastic
- Perimembranous Ventricular Septal Defect as a Transcatheter Aortic Valve Implantation (TAVI) ComplicationValvular
- Primary Cardiac Diffuse Large B-cell Lymphoma of the Left VentricleMasses
- Burned Out Extramedullary Hematopoiesis with Fatty Replacement in Beta ThalassemiaMetabolic
- Luxatio Erecta (Inferior Glenohumeral Dislocation)Trauma
- Benign Solitary Fibrous Tumor of the PleuraNeoplastic
See all cases from September 20, 2014 →
Related Aorta & Arteries cases
- Recurrent Laryngeal Nerve Paralysis (Hoarseness) due to Thoracic Aortic Aneurysm
- Mycotic Pseudoaneurysm of the Aorta
- Undiagnosed Double Aortic Arch in an Elderly Adult
- Endoleak due to Stent Buckling and Migration in Thoracoabdominal Aortic Aneurysm
- Takayasu's Arteritis with Aortic Arch Thickening and Multiple Surgical Grafts
- Aortic Arch Dissection