SINUS OF VALSALVA ANEURYSMS INVOLVING BOTH CORONARY OSTIA

Sinus of Valsalva aneurysms are a rare cause of angina or myocardial i nfarction. We describe a patient with unstable angina and massive unru ptured aneurysms of both coronary sinuses causing severe distortion of both coronary ostia, to our knowledge not previously reported. This u nusual patient underwent aortic valve replacement, ascending aortic re pair, and coronary artery bypass. At 11-year follow-up, she had develo ped severe mitral stenosis and prosthetic aortic valve stenosis. Revie w of the literature reveals 30 reported cases of Sinus of Valsalva ane urysm complicated by coronary insufficiency or infarction, involving e ither the left (20 cases) or the right coronary sinus (10 cases). We e mphasize the poor outcome of these patients, especially if treated con servatively. (C) 1993 Wiley-Liss, Inc.