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Complicated ruptured sinus of Valsalva: cardiac computed tomographic angiography (64 slice) predicts surgical appearance and obviates need for invasive cardiac catheterization

^a University of San Diego School of Medicine, San Diego, CA, USA
^b Cedars Sinai Medical Center, Los Angeles, CA, USA
^c Cardiovascular Research Foundation of Southern California, 414 North Camden Drive, Beverly Hills, CA, USA

*Corresponding author. Tel.: +1 310 278 3400.

E-mail address: Karlsberg{at}cvmg.com (R.P. Karlsberg).

We present a case report of a ruptured sinus of Valsalva aneurysm (SVA) that presented as aortic insufficiency following bacterial endocarditits in a cardiac transplant patient. Cardiac computed tomographic angiography (CCTA) including volume rendered images predicted the appearance of the fistula entrance and defined spatial relationships facilitating the surgical approach. CCTA ability to define the coronary anatomy obviated the need for invasive coronary angiography. The use of this imaging modality especially with three-dimensional spatial visualization, and multiphase cine angiography can add significant value to the care of a patient with ruptured sinus of Valsalva.

Key Words: Cardiac computed tomographic angiography; CT angiography; Rupture sinus of Valsalva; Aorta; Aortic valve