Causes of sinus of valsalva aneurysm. A rare case of echocardiography of sinus of valsalva aneurysm with discharge into the right ventricle
A sinus of Valsalva aneurysm is a rare congenital or acquired heart defect that is a finger-like or sac-like protrusion of the aortic wall near the semilunar valves. In most cases, this defect is congenital and occurs in boys.
Features of the disease
Aneurysm of the sinus of Valsalva most often occurs in the area of the right coronary sinus, in a quarter of cases in the area of the posterior (non-coronary) sinus, and in only five percent of patients it is registered in the area of the left coronary sinus. Occasionally, an aneurysm of all three sinuses occurs simultaneously, but similar case
so rare that it does not occur in the practice of most cardiac surgeons. The aneurysmal sac can reach a size of three centimeters.
Any of the defects can develop with or without rupture of the aneurysm in the presenting parts of the heart. In half of the cases, congenital aneurysm of the sinuses of Valsalva is combined with other heart defects. This is mainly aortic insufficiency, and.
- Very often, an aneurysm ends in one or more perforations that allow the aortic root to communicate with the corresponding cardiac chamber. Doctors identify several patterns of aneurysm rupture in certain parts of the heart.
- Left and central right coronary sinus aneurysms typically rupture into the outflow tract of the right ventricle.
- An aneurysm of the right part of the right sinus ruptures either into the cavity of the right atrium or into the inflow tract of the right ventricle.
Aneurysms of the left coronary sinus, which are very rare, usually rupture extracardially, into the cavity of the right atrium or right ventricle.
Read on to learn more about the causes of root aneurysm at the level of the sinuses of Valsalva.
Causes The main cause of aneurysm of the sinuses of Valsalva is considered to be poor heredity. People whose close relatives suffer from various heart muscle defects are many times more likely to have a child with the defect. Difficult pregnancy and poor development
The formation of this defect is based on the weakness of the connection between the fibrous ring and the aortic wall, which leads to weakening of the media (the middle lining of the aorta) and the formation of an aneurysm. At the time the child is born, the defect may not be detected. Later, throughout life, the aneurysmal sac increases in size, the walls become thinner and, as a result, rupture. Aneurysm rupture in a patient occurs between the ages of twenty-five and forty, but it also happens at childhood.
Acquired ASV can occur after suffering complex inflammatory and degenerative diseases, and severe injuries chest. All these reasons lead to dystrophy connective tissue, which is located on inner surface sinuses.
Symptoms
In young children, sinus of Valsalva aneurysm is almost always asymptomatic. Characteristic signs can only appear in the presence of breakthroughs that occur during physical activity:
- racing heartbeat;
- nausea;
- pale appearance;
- loss of consciousness;
- sharp chest pain;
- dyspnea;
- dizziness.
Ailments occur with a sharp and gradual deterioration in well-being. This factor depends on the size of the rupture and the volume of blood dumped into the chambers of the heart.
Diagnostics
Physically, you can identify some signs of an aneurysm of the sinuses of Valsalva:
- continuous and loud systolic murmur upper sections breasts;
- pulmonary wheezing;
- pastoral tremors;
- murmur from the back at the base of the heart.
Diagnostics goes like this:
- Electrocardiography does not show any specific changes. In some cases, overload of both ventricles and atrioventricular block, as well as junctional rhythm, are noticeable. Phonocardiography reveals high-amplitude noise.
- Echocardiography determines the condition of the sinuses, proximal aorta, aortic valve and the entire surrounding structure. Transesophageal echocardiography can be used to find exact location rupture and determine the degree of bleeding.
- X-ray thoracic shows an increased volume of the heart, especially its right department, and an increased pulmonary pattern.
- Using retrograde aortography (injection of a contrast agent into the aortic root), it is possible to distinguish the location of the aneurysmal sac, its size and the presence of perforations.
- Also, to identify this heart defect, a cardiologist may prescribe MRG of the heart muscle and ventriculography.
You will learn about what an aneurysm of the sinuses of Valsalva looks like in the following video:
Treatment
Medicinal and therapeutic
Conservative treatment of aneurysm of the sinuses of Valsalva is aimed at hemodynamic stabilization, elimination of arrhythmia, prevention and treatment infective endocarditis and cardiac ischemia.
It is important to know what pills and other medications are used for aortic aneurysm of the sinus of Valsalva. Apply ACE inhibitors, diuretics, nitrates and β-blockers. Standard prophylaxis for endocarditis is performed.
Read below to learn how to recover from an aortic aneurysm of the sinus of Valsalva using surgery.
Surgery for aortic aneurysm of sinus of Valsalva
Elimination of DIA is only possible surgically- through surgery. Repair of aneurysm of the sinuses of Valsalva is performed. Surgical intervention performed when connecting artificial blood circulation. Cardiac surgeons perform surgery through the right side of the heart muscle.
Resection of the aneurysm is carried out, followed by plastic surgery and suturing, which are strengthened with special gaskets. If necessary, aortic valve replacement and additional valve repair are also performed.
When an aneurysm of the sinuses of Valsalva ruptures, transcatheter closure is performed. It is carried out under the control of echocardiography using special devices. Plastic surgery of sinus of Valsalva aneurysm results in 100% recovery.
Scheme of supracoronary replacement of the ascending aorta
Disease prevention
Prevention of the disease includes:
- conducting healthy image life;
- walks in the open air;
- lack of physical activity;
- regular monitoring by a cardiologist;
- specialist consultations.
Complications
Possible complications with this heart defect:
- myocardial ischemia and angina pectoris;
- infective endocarditis (very often this disease is associated with microscopic ruptures);
- acute or progressive sinus of Valsalva with congestive heart failure or aortic valve regurgitation;
- compression of the conduction system of the heart muscle followed by its blockade;
- aortopulmonary or aortobronchial fistula;
- systemic embolism due to impaired blood flow through a dilated, unruptured sinus.
Forecast
Fatal cases mainly occur with rupture of an aneurysm of the sinuses of Valsalva followed by acute severe aortic valve insufficiency. If the resulting sinus rupture is not operated on, death occurs after about a year, sometimes a little later.
After surgery, the prognosis for survival is very good, especially if there is no damage to the aortic valve. The fatal outcome is only five percent of the total number of patients.
The prognosis for patients with unruptured defects is unknown, since the disease is completely asymptomatic.
Dilatation of the aorta at the level of the sinuses of Valsalva
Asked by: Valentina
Female gender
Age: 51
Chronic diseases: not specified
Hello, after an echocardiographic study, the conclusion was made: Dilatation of the aorta at the level of the sinuses of Valsalva. AK seal. Regurgitation in the aortic canal, stage 1. Regurgitation on the mitral valve, stage 1. Regurgitation on the tricuspid valve, stage 1. Valve regurgitation pulmonary artery. What is it and how to treat it?
Aneurysmal dilatation of the aorta, dilatation of the ascending valve 45 mm, calcification of the aortic valve After fluorography performed on November 28, 2017, the image showed a suspicion of inflammation lymph node root right lung, fluorography was prescribed against the background elevated temperature, blood pressure 140/90, bone aches. After fluorography it was recommended CT scan lung 12/01/17 A computed tomography scan was performed, which showed that there were no problems in the lungs, but an enlargement of the ascending aorta with a diameter of 45 mm was detected, and calcification of the aortic valve was noted. In other levels the aorta is 26mm. In 2013 there was one attack with severe pain behind the sternum, heavy sweating, pressure 75/45, repetition was a year later in 2014. This is not observed in subsequent years. Please tell me how to treat this, is surgery necessary,
3 answers
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Hello! These are changes in blood vessels and heart that occur as a result of high blood pressure, and/or coronary disease heart, or age, or individual anatomical features. It cannot be treated on its own and does not threaten your life. Monitor your blood pressure, see a cardiologist, have an echocardiogram once a year.
Be healthy!
Elena 2015-03-20 23:04
Hello! The child is 11 years 6 months old, Height 146cm, Weight 30kg, has been actively practicing Taekwondo for 4 years. We wanted to enter the cadet corps. For this we did an ultrasound of the heart (for the first time).
The doctor wrote: The heart is formed and positioned correctly. The cavities of the heart are not enlarged. The myocardium is not thickened. General contractility and diagnostic function ventricles are within normal limits. False chord in the cavity of the left ventricle as a normal variant. The septa are intact. The valves have not been modified and are functioning normally. Large vessels and pericardium without pathology. The aorta is slightly dilated at the level of the sinuses of Valsalva.
Conclusion: No evidence of congenital heart disease was identified.
Slight dilatation of the aorta at the level of the sinuses of Valsalva. Observation by a cardiologist. ECHO-CG control after 12 months.
MEASUREMENTS
M mode 2D mode
IVS (mm) 6 Aorta, sinuses (mm) 28
LV EDV (mm) 42 Aorta, ascending limb (mm) 22
LV LV (mm) 6 LA (mm) 24
LV ESD (mm) 26
PV(%) 69
FU (%) 38
Dopplerography
VEMK(m/s) 1.06
TK (m/s) 0.66
PC (m/s) 0.8
JSC Voskh. (m/s) 1.4
JSC Nisch. (m/s) 1.4
Tell me how serious this diagnosis is, and whether it could be an obstacle to entering the cadet corps. Thank you.
Hello! There is no danger to life. It is necessary to track the dynamics. I can’t answer you about the cadet corps, I don’t know their rules, this needs to be discussed with the doctors of the admissions committee.
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The sinuses (sinuses) of the aorta at the site of attachment of the semilunar valves of the aortic valve are named after the Italian anatomist Valsalva. With aneurysmal expansion of the wall in this area, a heart defect occurs, most often due to congenital weakness of the connective tissue.
The manifestation of signs of the disease occurs when an aneurysm ruptures - pain in chest, drop in cardiac activity. Treatment requires angioplasty using a heart-lung machine.
Read in this article
Reasons for development
Congenital aortic aneurysm in the area of the sinuses of Valsalva is the most common variant of this pathology; it is found more often in boys.
All three sinuses can be affected, but in the vast majority it is the right coronary sinus. The size of the formation varies from 1 to 3 cm.
Isolated bulging of a vessel in the root zone is rare; patients usually suffer from, or, narrowing of the pulmonary artery. Towards the formation of this aortic disease
- cite the effects of adverse factors on a pregnant woman:
- viral infections,
- syphilis,
- diabetes,
- intoxication,
- medicines,
- taking alcohol or drugs,
- smoking,
- harmful working conditions,
- toxicosis,
threat of miscarriage.
The formation of the congenital defect is based on the weakening of elastin fibers at the site of attachment of the aorta to the valve ring. This occurs during the period of intrauterine development. After birth, there is no aneurysm, and as it grows, the wall of the vessel becomes thin and ruptures under the influence of blood pressure.
Such an event can occur in childhood, but most often patients live to be 20–30 years old, unaware of their illness. Acquired pathology develops after previous tuberculosis , syphilitic or rheumatic infection, against the background of traumatic injury. At
strong impact
In the chest, an aneurysm can rupture with the passage of blood into the cavity of the pericardial sac. This causes death almost instantly. Symptoms of sinus of Valsalva aneurysm.
The rupture of the aneurysmal sac occurs in the heart cavity. This leads to the discharge of blood into the corresponding chamber. If the formation is located in the right or left coronary sinus, then the half of the heart of the same name becomes full. Not coronary sinus is close to the right atrium, so the aneurysm ruptures into it.
The course of the defect may be gradual clinical signs. This is only possible with the simultaneous development of another congenital anomaly structure of the heart, which compensates for the discharge of blood. In this case, patients complain of compression of the coronary arteries, fainting states associated with transverse heart block. If there is only an aneurysm of the sinus of Valsalva, then the condition worsens very quickly.
An increase can lead to a rupture blood pressure blood, intense exercise stress, blow to the chest, trauma, inflammatory process in the myocardium or endocarditis.
Patients experience unbearable pain in the chest and abdomen (due to liver overflow), difficulty breathing, rapid heartbeat, dizziness.
The ejection of blood from the ventricles decreases, which is accompanied by an increase in circulatory failure and pulmonary edema. With sudden overflow of the right ventricle, cardiac arrest may occur, since its myocardium is much weaker than that of the left.
The pressure decreases, when listening to the heart, the noise of a “running machine” and trembling during contraction are detected.
In the period before the rupture, some patients hear a noise in systole or diastole along the edge of the sternum on the left side.
Watch the video about congenital heart defects:
Diagnosis of the condition
To confirm the diagnosis, an instrumental examination is performed.
ECG, EchoCG It is impossible to draw a conclusion about the presence or absence of an aneurysm in the patient. If there is an overflow of the right or left half, then indirect signs
overload. As with other anomalies of the heart structure, data obtained from ultrasound are used to diagnose aortic heart disease. It can be performed either transthoracically or with.
- In this case, the following symptoms are revealed:
- dilated sinus, which protrudes into one of the chambers of the heart;
- discharge of blood during diastole (with breakthrough);
reverse blood flow at the aortic valve.
X-ray and other methods
With a plain chest x-ray, you can notice an enlarged shadow of the heart, especially the right side, and an enhanced pulmonary pattern due to the overcrowded right ventricle. For determining Before surgical correction, patients are prescribed aortography (visualization of the ventricles), MRI as an independent method or in conjunction with angiography.
Treatment of sinus of Valsalva aneurysm
The abnormal structure of the sinus of Valsalva can only be eliminated with surgical treatment. In this case, the following actions are provided:
- Connection to a heart-lung machine.
- The protrusion is stitched and cut off.
- The defect site is covered with a synthetic patch from the side of the aorta or heart chamber.
An alternative technique is to retract the sac into the lumen of the aorta, then it is sutured and partially removed. The difficulty of performing the operation arises in the immediate vicinity of the aneurysm and coronary artery. In this case, preference is given to suturing the cavity from the side of the heart. At the same time, correction of other malformations or plastic surgery of the aortic valve can be carried out.
Prognosis for patients
The severity of this disease is due to the fact that the aneurysm does not manifest itself until the moment of rupture. And when this event occurs, surgery is indicated at the earliest short time, which is difficult to implement, since neither the doctor nor the patient has suspicions about the impending danger.
If a large defect occurs between the aorta and the heart, it causes a large shunt of blood and death due to acute heart failure.
Even with a relatively small breakthrough, patients cannot live more than 2 years with such a defect, since blood stagnation inevitably develops in the arterial and venous system, ending in cardiac arrest.
If surgery is performed in a timely manner, the chances of survival increase significantly. These patients have a gradual return to normal activities but should be monitored by a cardiologist for a period of time. long period time (at least a year).
Sinus of Valsalva aneurysm occurs due to weakness aortic wall at the valve attachment point. The disease is often of congenital origin. Symptoms before rupture are absent or not specific. The aneurysm ruptures into a nearby part of the heart with the development of acute or chronic failure
blood circulation
For making a diagnosis, the most informative are cardiac ultrasound and MRI. Treatment is only surgical; without it, patients are doomed.
If a cardiac aneurysm is detected, surgery may be the only chance for salvation, only with it the prognosis improves. It is generally possible to live without surgery, but only if the aneurysm, for example, of the left ventricle, is very small.
The aortic valve, consisting of the right, left and posterior semilunar valve, in other words, is called the sinus of Valsalva.
Aneurysms of the sinuses of valsalva.
Aneurysms of the sinuses of valsalva occur as a result of a sudden genetic mutation. This abnormality is extremely rarely diagnosed immediately after birth. There are opinions that aneurysms of the sinuses of valsalva arise as a result of weakness of the connection of the aortic wall. Scientists have not determined the period for the onset of progression of this pathology. According to the theory, an aneurysm can begin in the embryonic period. There are a number of reasons that can trigger the occurrence of an aneurysm in children.
- An important reason the formation of an aneurysm may be the development of subpulmonary deviation of the interventricular septum.
- Trauma to the aortic root can affect sinus rupture.
- Genetic predisposition. At large list various ailments that are directly related to diffuse expansion of the aortic root.
- Tertiary syphilis.
The above deviation manifests itself as an immediate, sudden deterioration general condition sick. Shortness of breath occurs and the heart rate may increase, resulting in heart failure. Aneurysms of the sinuses of Valsalva can be diagnosed by listening to a systolic murmur on the left side of the chest. If the patient is prescribed an electrocardiogram, no changes will be detected. As a result of the X-ray, the patient will find an enlarged heart. The baby can grow and develop without any abnormalities. But over the course of its life, an aneurysm can increase in size, and accordingly, the walls begin to become thin, resulting in a rupture. As a result of the rupture, the patient experiences a disturbance in the movement of blood in the heart, increases pulmonary pressure.
In order to confirm their assumptions, qualified specialists prescribe echocardiography to the patient, which will show an aneurysm of the sinuses of Valsalva, and sometimes even a rupture. To determine this pathology, the patient may also be prescribed aortography. Aortography is based on full examination aorta using special contrast agents.
Treatment of this disease can occur with the help of certain medicines. The course of treatment is based on maximum prevention of progression of this process. As a rule, patients are prescribed medications that can lower blood pressure, which will result in a decrease in pressure on the walls of the aorta. If drug treatment did not show the desired result, the patient is scheduled for surgery. The patient undergoes resection of the aneurysmal sac or regular suturing of the resulting hole.
Required condition In order for the patient to undergo surgery, the ascending aorta is clamped, as well as the use of cardioplegia to inject a cardioplegic solution directly into the aortic root, but only when the right side of the heart is initially opened, as well as the base of the aneurysm is clamped. Surgical intervention is based not only on resection, but also on maximum strengthening of the place where the walls of the aorta connect with the aortic valve ring. If necessary, the patient does reconstructive surgery or prosthetics of the above type of valve.
Dilation of the sinuses of valsalva.
Sinus of valsalva is a rare congenital heart defect. Dilatation of the sinuses of valsalva is in other words called an aneurysm. This pathology occurs as a result of the fact that the walls vascular system become weak, and accordingly, the full formation of the vascular system in utero is disrupted.
The echocardiographic manifestation of this deviation is a noticeable protrusion of the sinus wall in a certain cavity of the heart. When undergoing Doppler sonography, the blood flow in the required cavity is recorded. It should be noted that in childhood, the diagnosis of dilatation of the sinuses of valsalva is usually non-coronary, which means that the dilation of the sinuses may not progress to the stage of an aneurysm. A long-term detailed examination of this category of patients indicates the likelihood of the benign nature of the above deviation, as well as its sudden disappearance according to the degree of growth of the small patient.
When performing resection of the enlarged sinuses of valsalva, the probability of death is reduced to 12–38%. The likelihood of complications occurring after the patient has undergone resection is observed in only 5–10% of patients.
Idiopathic dilatation of the aorta and aortic sinuses (sins of Valsalva) may manifest as dilatation of the aortic root or aortic bulb (anuloaortic ectasia) or the ascending aorta, as well as dilatation of all three aortic sinuses.
Dilatation of the root or ascending part of the aorta and sinuses of Valsalva may be associated with systemic connective tissue dysplasia, especially with differentiated dysplasia (Marfan syndrome, Ehlers-Danlos syndrome, etc.) or be idiopathic in nature, although in these cases idiopathic dilatation is combined with other stigmas dysembryogenesis (dilatation mitral orifice, prolapse mitral valve, false chords of the left ventricle, idiopathic dilatation of the pulmonary artery trunk, etc.). Dilatation of the aortic bulb can lead to a pear-shaped deformation of the aortic root, called anuloaortic ectasia. This may be accompanied by aortic valve prolapse, relative aortic valve insufficiency and moderate degree aortic regurgitation.
Dilatation of the sinuses of Valsalva is usually not accompanied by hemodynamic and manifest symptoms. clinical changes. More often (69% of cases) the right aortic (coronary) sinus is affected, much less often (26% of cases) - the posterior (non-coronary) and very rarely (less than 5% of cases) - the left coronary sinus. Dilatation of the non-coronary sinus does not exceed 3-
mm. On auscultation, intermittent “clicks” or clicks can be heard (Belozerov Yu.M., Bolbikov V.V., 2001; Bankle G., 1980).
Chest X-ray. When the root or ring of the aortic valve expands, any deformation of the aorta can be completely hidden behind the shadow of the heart. It is advisable to perform radiography in a lateral projection.
Echocardiography. In one-dimensional mode, premature opening of the aortic valve is detected; dilatation of the aortic root; paradoxical systolic movement back wall aorta; partial early midsystolic closure of the aortic valve.
In two-dimensional mode, dilatation of the aortic ring is determined in cross section at the level great vessels; prolapse of the aortic valve into the left ventricular outflow tract. Doppler echocardiography can reveal a small degree of aortic regurgitation. Transesophageal echocardiography provides extremely informative images of the aorta, especially when aortic wall dissection is suspected (Linkau T, 2000).
The course is often favorable, asymptomatic, and in rare cases, when examined over a period of 2-3 years, even spontaneous disappearance of dilatation of the sinuses of Valsalva may be observed (Belozerov Yu.M., Bolbikov V.V., 2001). However, aneurysmal dilatation of both the aortic root and sinuses of Valsalva can also be detected.
Aneurysms of the sinuses of Valsalva can be either congenital, idiopathic, or acquired, associated with syphilitic, fungal infection, and in children and adolescents - more often with insufficiency elastic fabric with connective tissue dysplasia syndrome. A congenital aortic sinus aneurysm is a sac-like or finger-like outgrowth of the parietal sinus wall that protrudes into the underlying cardiac chamber. If an aneurysm ruptures in the form of a papillary perforation at its apex, then arteriovenous shunting of blood from the aorta to one or another adjacent (usually right) chamber of the heart occurs. Acquired aneurysms usually have big sizes, spread upward and more often rupture outside the heart, and congenital aneurysms are almost always small and rupture into the chambers of the heart. However, their differentiation is often impossible.
Congenital aneurysms of the sinuses of Valsalva are clinically and sectionally detected from 0.1-0.15% to 0.3-3.5% in people with birth defects heart, several times more often in males. Most often (25-40% of cases) this anomaly is combined with VSD, less often with a bicuspid aortic valve and coarctation of the aorta (Bankle G., 1980; Belokon N.A., Podzolkov V.P., 1991). An aneurysm develops gradually and, since it is not hemodynamically and clinically manifested, it can be first detected only when it ruptures. However, in cases where the aneurysm of the sinuses of Valsalva protrudes into the outflow tract of the right ventricle, it can create an obstruction to blood flow into the trunk of the pulmonary artery (Belokon N.A., Podzolkov V.P., 1991).
Aortic aneurysms, especially those characteristic of Marfan syndrome, tend to gradually enlarge. The critical diameter of aortic aneurysms in the chest is more than 4 cm in terms of the threat of dissection and rupture. Dissection and rupture (especially of the ascending aorta - 70% of cases) are facilitated by concomitant arterial hypertension, coarctation of the aorta or aortic insufficiency (Litsigeu T, 2000).
A complication of aneurysm of the sinuses of Valsalva by rupture is most often observed between the ages of 16-18 years and 40 years. Only 15% of patients die before the age of 20 years, 25% at the age of 20-30 years and 60% at the age of 30-40 years (Bankle G., 1990). Aneurysm rupture is often associated with sudden physical stress. Since aneurysms of the sinuses of Valsalva more often break into the right cavities of the heart, with the formation of a fistula, this is accompanied by acute arteriovenous shunting of blood into the right parts of the heart and pulmonary circulation, overloading almost all parts of the heart. Severe chest pain appears due to a decrease in coronary blood flow, tachycardia and shortness of breath associated with a sharp increase in pulmonary blood flow. Symptoms characteristic of a patent ductus arteriosus (botallus ductus arteriosus) appear (decrease in diastolic blood pressure and increase in pulse blood pressure, systolic-diastolic, continuous “machine” noise). However, unlike a PDA, the murmur is better heard not at the base of the heart, but in the third or fourth intercostal spaces to the left and right of the sternum.
On the ECG, against the background of signs of overload and hypertrophy, more often of the left parts of the heart, incomplete and even complete atrioventricular block may appear, caused by mechanical compression by the aneurysm and trauma to the atrioventricular pathways (Bankle G., 1980; Belokon N.A., Podzolkov V.P. ., 1991).
Echocardiography. With an aneurysm of the ascending aorta, dilatation of the aortic root of more than 42 mm is detected; separation of structures of the anterior wall of the aorta (16-
mm) and rear wall (10-13 mm); parallel movement of separated aortic walls; thicker outer than inner wall aorta; mid-systolic closure of the aortic valve, aortic insufficiency.
With an aneurysm of the sinuses of Valsalva, dilatation of the aorta is detected at the level of the sinuses of Valsalva (more than 40 mm); signs of compression of the left atrium; increasing the distance from the aortic cords to the underlying wall during systole; systolic bulging of the aortic wall; bulging of one or more sinuses in the parasternal short-axis view at the level of the aortic valve. Dopplerography allows us to establish the presence of a breakthrough of the sinus of Valsalva into the corresponding chamber of the heart and the amount of discharge (Belozerov Yu.M., Bolbikov V.V., 2000).
Drug treatment for aneurysmal dilatation of the aorta and sinuses of Valsalva is aimed at preventing the progression of the process. In particular, patients with anuloaortic ectasia and media degeneration may be prescribed drugs from the group of β-blockers and other means of lowering blood pressure to reduce pressure on the aortic wall and the degree aortic insufficiency(Ypskau G, 2000).
Like all anomalies of the heart and blood vessels, severe dilatation and aneurysms of the aorta or sinuses of Valsalva can be complicated by secondary infective endocarditis with predominant damage to the aortic valve and the development of its insufficiency. Therefore, during clinical observation and management of such patients, it is necessary to use all means of primary and secondary prevention of infective endocarditis. In cases of complications of an aneurysm of the sinuses of Valsalva, rupture is performed surgical correction: resection of the aneurysmal sac and suturing of the resulting hole with separate sutures or closing with a patch (Belokon N.A., Podzolkov V.P., 1991).