Cardiovasc Imaging Asia.  2019 Jul;3(3):93-95. 10.22468/cvia.2018.00283.

Role of Cardiac MRI in Complicated Cardiac Defects

• Khan Y
• Pervez MB
• Fatimi S

• KMID: 2465759
• DOI: http://doi.org/10.22468/cvia.2018.00283

Abstract

Sinus of Valsalva rupture is a rare condition that results in aortocardiac shunt. Although the investigation of choice is transthoracic echocardiography, the gold standard is cardiac catheterization. We present a case of a young male with acute onset heart failure. Acute coronary syndrome blood workup was unremarkable. Transthoracic and transesophageal echocardiography revealed mild right atrial dilation with a Gerbode shunt. Right heart catheterization showed left to right shunt suggestive of acquired acute onset shunting. Eventually, a cardiac MRI revealed a ruptured sinus of Valsalva opening into the right atrium as the cause. The patient was taken to the operation theater where an aortobicaval bypass was established. A horizontal aortotomy revealed a sinus of Valsalva aneurysm arising from the right coronary sinus which was repaired using a Dacron patch. Postoperative transthoracic echocardiography showed no defect. In summary, cardiac MRI is an excellent tool for establishing a definite diagnosis for complicated cardiac defects.

Keyword

Ruptured aortic aneurysm; Congenital defects; Magnetic resonance imaging, functional; Cine magnetic resonance imaging

MeSH Terms

Acute Coronary Syndrome
Aneurysm
Aortic Rupture
Cardiac Catheterization
Cardiac Catheters
Congenital Abnormalities
Coronary Sinus
Diagnosis
Echocardiography
Echocardiography, Transesophageal
Heart Atria
Heart Failure
Humans
Magnetic Resonance Imaging*
Magnetic Resonance Imaging, Cine
Male
Polyethylene Terephthalates
Rupture
Sinus of Valsalva
Polyethylene Terephthalates