Rupture of Aortic Sinus Aneurysm Caused by Trauma

Background: Sinus of Valsalva aneurysm is just an uncommon cardiac anomaly, a congenital or acquired cardiac defect that is present in roughly 0.09% of the general population. With an incidence of less than 1% of opening heart surgery cases. Case Presentation: A sinus of Valsalva aneurysm is just an uncommon cardiac anomaly. The aneurysm usually ruptures into the cardiac cavity. The most frequent complication of SVA is rupture into the right atrium or right ventricle. We reviewed 2 cases of rupturing sinus aortic aneurysm. Conclusion: Echocardiography examination needs to monitor the diameter of the aortic sinus, aortic root and aortic valve, especially in the army.


Background
Aneurysms of the sinuses of Valsalva are de ned as dilatation of the aortic root region between the aortic annulus and the sinotubular junction.They may be congenital, especially secondary to connective tissue disorders or in conjunction with congenital cardiac defects, or acquired such as secondary to infections or trauma [1].Sinus of Valsalva aneurysm is just an uncommon cardiac anomaly,a congenital or acquired cardiac defect that is present in roughly 0.09% of the general population.With an incidence of less than 1% of opening heart surgery cases.The gold standard treatment for Sinus of Valsalva aneurysm consists of complete replacement of the aortic root and valve [2,3].Aortic sinus aneurysm is a rare and usually asymptomatic lesion.Rupture leads to chest tightness and dyspnea, suggesting left or right heart failure. Rupture of Valsalva sinus remains a very rare and deadly complication of Valsalva sinus aneurysm with a high mortality rate.Surgery is the primary treatment [4,5].

Case Presentations
Case 1: A 40-year-old woman.The car accident caused chest tightness. Echocardiography showed rupture of sinus aortic aneurysm.In the short axis view of the aorta, there was a tubular echo 4.2mm wide and 7.2mm long at the right coronal valve below the septal tricuspid valve. It communicates with the right ventricle.The blood ow signal was chaotic and colorful. The frequency spectrum was biphasic and bidirectional continuous asthmatic ow. The blood ow velocity was 4.7 m/s and PG87 mmHg. No ventricular septal defect was found. Severe aortic regurgitation.Ultrasonographic impression: ruptured right coronary sinus aneurysm to the right ventricle was examined. The above viewpoint was con rmed by operation and aortic valve repair was performed (Fig. 1).

Case 2:
A 62-year-old woman,also car accident.Along with the cardiac cycle, membranous oval echo was found in the right atrium and right ventricle, with the size of 21x20 mm. It was linked to the noncoronoid valve, and its internal blood ow was colorful, which had been ruptured. The operation con rmed that the aortic sinus aneurysm noncoronoid valve ruptured to the right heart system (Fig. 2).

Conclusions
Aortic sinus aneurysm often does not have symptoms and sign. Rupture of an aortic sinus aneurysm and permeableness part of ventricular septal defect are di cult 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 ow of ventricular septal defect is systolic blood ow. The blood ow 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].
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 tra c 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 uid in the trauma setting [16].But professional echocardiography is mandatory.Whether eFAST + echo is better.
Aortic root sizes are in uenced 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 rst-class hospital on the battle eld.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.

Declarations
Ethical Approval and Consent to participate Figures Figure 1 There was continuous blood ow signal from left to right in the periventricular septum.