Aortic sinus aneurysm often does not have symptoms and sign. Rupture of an aortic sinus aneurysm and permeableness part of ventricular septal defect are difficult to distinguish, and often complicated with ventricular septal defect, trauma and other factors.Ventricular septal defect may be present in approximately 50%-60% of patients with Valsalva sinus aneurysm[6].The blood flow of ventricular septal defect is systolic blood flow. The blood flow of ruptured aneurysm is continuous.
Aneurysm of the sinus of Valsalva is a rare congenital cardiac anomaly. It forms an outpouring that progresses like a windsock, and it may rupture producing aortic regurgitation, cardiac tamponade, congestive heart failure, conduction abnormalities, and stroke[7].Which has been potential for spontaneous rupture into other cardiac chambers or the pericardial space. A ruptured SVA is placed under a very poor prognosis.The development of a shunt between the sinus of Valsalva and right-sided cardiac chambers results in a continuous murmur on examination[8].Rupture is a catastrophic complication with high mortality without urgent surgical intervention[9].
Study[10],surgical intervention is the main treatment for a ruptured congenital sinus of Valsalva aneurysm (SVA).The SVAs originated from the right coronary sinus (79.7%), the non-coronary sinus (19.6%) and the left coronary sinus (0.7%) but ruptured into the right ventricle (58.4%) and the right atrium (41.3%). The most commonly associated deformities were a ventricular septal defect (46.3%), aortic valve regurgitation (33.2%) and tricuspid regurgitation (20.3%).
Sinus of Valsalva aneurysm results from dilation of an aortic sinus,can be life-threatening if it ruptures.Sudden aneurysm rupture can trigger rapidly progressive heart failure.Ruptured sinus of Valsalva aneurysm repair and valve replacement are usually required for treatment.Transcatheter closure has emerged as an effective alternative to surgical management.Transcatheter closure of ruptured sinus of Valsava aneurysm is a safe and effective strategy and associated with a good long-term outcome.[11, 12, 13, 14]
A formal echocardiographic approach in a general intensive care unit requires a 24 hour availability of an expert in echocardiography, who could not be easily found[15].In the real world, it does. Attention is usually focussed on organ rupture in traffic accidents.Unexplained dyspnea, chest tightness, palpitations, do echocardiography are useful.
Systematic review and meta-analysis suggests that e-FAST(extended focused abdominal sonography for trauma) is used as a bedside tool for ruling in pneumothorax, pericardial effusion, and intra-abdominal free fluid in the trauma setting[16].But professional echocardiography is mandatory.Whether eFAST + echo is better.
Aortic root sizes are influenced by hypertensive status, age and gender[17].In primary hospitals, the diameter of aortic sinus, aortic root and aortic valve were not measured by Echocardiography.Echocardiography examination needs to monitor the diameter of the aortic sinus, aortic root and aortic valve,especially in the army.
There are at most two doctors in the first-class hospital on the battlefield.The training of military health personnel must include ultrasound examination. It is recommended that they can use not only the abdominal probe, but also the cardiac probe to examine the abdomen.If necessary, ultrasound-guided pericardial effusion puncture can also be used.Portable equipment can detect the key points of the wounded in time.