LETHAL COURSE OF A CONGENITAL ANEURYSM OF THE RIGHT SINUS OF VALSALVAWITH RUPTURE INTO THE RIGHT ATRIUM - A CASE-REPORT WITH REVIEW OF THELITERATURE

In a 24-year-old female patient with sudden collapse an acute tricuspi d insufficiency was presumed by echocardiography after the exclusion o f pulmonary embolism. Aortography, however, revealed an aneurysm of th e right sinus of Valsalva which had ruptured into the right atrium. De spite emergency surgery the patient died in protracted cardiac shock. Biopsy and autopsy showed pathognomonic findings of a congenital aneur ysm (medial degeneration, reduction of elastic lamellae). Aneurysms of the sinuses of Valsalva are mainly caused by a rare connatal defect o f the aortic wall; the right aortic sinus is involved most frequently, the sudden rupture uncovers the lesion. The characteristics of the re ported case are compared with the literature under special considerati on of etiology and pathologic anatomy of this unusual entity.