Myocardial Angina due to Compression of the Left Coronary Artery by a Large Aneurysm in the Left Sinus of Valsalva

(Department of Cardiovascular Surgery, Tsukuba Medical Center, Tsukuba, Japan)

Akito Imai Kanji Matsuzaki Tomohiro Imazuru
Tomoaki Jikuya
Sinus of Valsalva aneurysm is a rare cardiac disorder, and reports of its origin among in the left sinus are scarce. This report describes a 38-year-old man with an isolated extracardiac unruptured aneurysm of the left sinus of Valsalva. The patient presented with chest pain due to compression of the main trunk of the left coronary artery by the aneurysm. The aneurysm was resected, and the aortic root was reconstructed using the Bentall procedure. Concomitantly, coronary artery bypass grafting(LITA-LAD)was added. Postoperative native coronary flow was fully restored, and his anginal symptoms disappeared despite occlusion of the additional LITA-LAD anastomosis. This type of case would be considered to not require concomitant CABG, since the cause of the coronary artery stricture was compression by an aneurysm in the left sinus of Valsalva.
  Jpn. J. Cardiovasc. Surg. 40:54-57(2011)

Keywords:left sinus of Valsalva aneurysm, myocardial angina, bentall procedure, CABG