Advanced Cardiac Surgical Success
A rare and life-threatening ruptured sinus of Valsalva aneurysm (RSOV) opening into the right atrium was successfully repaired at Tulip Mediworld Superspeciality Hospital, resulting in complete haemodynamic stabilisation and an excellent recovery.
The Challenge: Initial Presentation
The patient presented with progressive breathlessness and intermittent chest discomfort, caused by a ruptured sinus of Valsalva aneurysm leading to acute left-to-right shunt, severe volume overload, and congestive cardiac failure.
This rare cardiac emergency posed multiple challenges:
- Rapid haemodynamic deterioration
- Severe right-sided chamber dilatation
- Pulmonary hypertension and valvular regurgitation
- High risk of sudden decompensation
Immediate surgical correction was essential for survival.
Diagnosis:
- Ruptured Sinus of Valsalva Aneurysm opening into the Right Atrium
- Congestive Cardiac Failure
- Systemic Pulmonary Arterial Hypertension
- Severe Tricuspid Regurgitation
- Moderate Pulmonary Regurgitation
- Mild Mitral Regurgitation
- Grossly dilated Right Atrium and Right Ventricle
- Cardiomegaly with preserved biventricular systolic function
- Diastolic Dysfunction – Grade II
- Moderate Pericardial Effusion
- Deranged Renal and Liver Function Tests (reversible)
- Associated Gout
Coronary Angiography (03/09/2025): Normal coronary arteries
Aortic Root Angiogram: Confirmed RSOV → Right Atrium shunt
Clinical Excellence: Diagnostic Accuracy
A comprehensive diagnostic protocol, including echocardiography, coronary angiography, aortic root imaging, ECG, and advanced laboratory evaluation, enabled:
- Early identification of RSOV rupture
- Exclusion of coronary artery disease
- Accurate haemodynamic assessment
- Safe surgical timing and planning
- Prevention of irreversible cardiac damage
Early diagnosis was pivotal in preventing fatal heart failure and pulmonary vascular collapse.
The Solution: Surgical Intervention & Treatment
Procedure Done
- Repair of ruptured sinus of Valsalva aneurysm to right atrium
- Closure performed using a tanned autologous pericardial patch
The surgery was performed under the leadership of Dr. Apurba Kumar Sarma, following international cardiac surgery protocols with meticulous intraoperative monitoring.
The Outcome: Recovery & Stabilisation
A Failing Heart Stabilised. A Life Restored.
- Complete closure of the abnormal shunt
- Resolution of congestive cardiac failure
- No residual defect on follow-up echocardiography
- Preserved ventricular function
- No neurological or surgical complications
- Smooth postoperative recovery
