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Aneurysms of Two Aortic Sinuses: Associated with Aortic Insufficiency, Perforation into the Left Ventricle, and Complete Heart Block with Prolonged Ventricular Arrest

Aneurysms of Two Aortic Sinuses: Associated with Aortic Insufficiency, Perforation into the Left... Abstract The occurrence of aneurysms of two aortic sinuses, either congenital or acquired, is rare; involvement of a single sinus, although reported with increasing frequency in recent years, remains an uncommon defect. Heart block is routinely cited in textbooks of cardiology as a possible complication of right aortic sinus aneurysms because of their proximity to the atrioventricular node or the bundle of His, yet only two instances of coexisting complete heart block and aortic sinus aneurysms are reported.1,2 Aortic insufficiency as a complication of single or multiple aortic sinus aneurysms is almost universal, being attributed to weakening and dilatation of the aortic ring by aneurysmal erosion.3 Complete heart block in this case was complicated by periods of ventricular asystole which soon became refractory to the usual modes of therapy, necessitating continual use of the electrical pacemaker for 15 days. Peculiar to the case to be reported here was a References 1. Performed by Drs. F. X. Byron and J. Fields. Eight hours postoperatively spontaneous idioventricular rhythm ensued at a rate of 70. Signs of heart failure diminished. The patient died on Sept. 3, 1955, when a sudden prolonged ventricular asystole did not respond to electrical stimulation. 2. Micks, R. H.: Congenital Aneurysms of All Three Sinuses of Valsalva , Brit. Heart J. 2:63, 1940.Crossref 3. Duras, P. F.: Heart Block with Aneurysm of the Aortic Sinus , Brit. Heart J. 6:61, 1944.Crossref 4. Snyder, G. A. C., and Hunter, W. C.: Syphilitic Aneurysm of the Left Coronary Artery with Concurrent Aneurysm of the Sinus of Valsalva, and an Additional Case of Valsalva Aneurysm Alone , Am. J. Path. 10:757, 1934. 5. Zoll, P. M.; Linenthal, A. J., and Norman, L. R.: Treatment of Stokes-Adams Disease by External Electric Stimulation of the Heart , Circulation 9:482, 1954.Crossref 6. Bellet, S.; Wasserman, F., and Brody, J. I.: Treatment of Cardiac Arrest and Slow Ventricular Rates in Complete A-V Heart Block: Use of Molar and Half Molar Sodium Lactate; a Clinical Study , Circulation 11:685, 1955.Crossref 7. Hufnagel, C. A.; Harvey, W. P.; Rabil, P. J., and McDermott, T. F.: Surgical Correction of Aortic Insufficiency , Surgery 35:673, 1954. 8. Pearce, M. L., and Nordyke, R.: Some Observations on the Effect of Heart Rate Controlled by an External Stimulator in Aortic Insufficiency , Am. J. Med. 22:498, 1957.Crossref 9. Lown, B.; Arons, W. L.; Ganong, W. F.; Vazifdar, J. P., and Levine, S. A.: Adrenal Steroids and Auriculoventricular Conduction , Am. Heart J. 50:760, 1955.Crossref 10. Jones, A. M., and Langley, F. A.: Aortic Sinus Aneurysms , Brit. Heart J. 11:325, 1949.Crossref 11. Venning, G. R.: Aneurysms of the Sinuses of Valsalva , Am. Heart J. 42:57, 1951.Crossref 12. Barnett, C. W.: Failure of Adequate Treatment in Preventing Cardiovascular Syphilis , Stanford M. Bull. 13:234, 1955. 13. Hood, B. J., and Mohr, C. F.: Microscopic Pathological Appearance of the Aorta in Treated and Untreated Patients with Syphilitic Aortitis , Am. J. Syph. 21:177, 1937. 14. Howe, E. G.: Microscopic Pathological Appearance of the Aorta in Treated and Untreated Cases of Syphilitic Aortitis , Am. J. Syph. 27:50, 1943. 15. Webster, B., and Reader, G. G.: Effect of Antisyphilitic Treatment on the Microscopic Appearance of Syphilitic Aortitis , Am. J. Syph. 32: 19, 1948. 16. Sinclaire, H. A., and Webster, B.: Effect of Penicillin Treatment on the Microscopic Appearance of Syphilitic Aortitis , Am. J. Syph. 38:54, 1954. 17. Turner, T. B., and Hollander, D. H.: Studies on the Mechanism of Action of Cortisone in Experimental Syphilis , Am. J. Syph. 38:371, 1954. 18. Koletsky, S.: Congenital Bicuspid Aortic Valves , Arch. Int. Med. 67:129, 1941.Crossref 19. Koletsky, S.: Acquired Bicuspid Aortic Valves , Arch. Int. Med. 67:157, 1941.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

Aneurysms of Two Aortic Sinuses: Associated with Aortic Insufficiency, Perforation into the Left Ventricle, and Complete Heart Block with Prolonged Ventricular Arrest

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1957.00260070140016
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Abstract

Abstract The occurrence of aneurysms of two aortic sinuses, either congenital or acquired, is rare; involvement of a single sinus, although reported with increasing frequency in recent years, remains an uncommon defect. Heart block is routinely cited in textbooks of cardiology as a possible complication of right aortic sinus aneurysms because of their proximity to the atrioventricular node or the bundle of His, yet only two instances of coexisting complete heart block and aortic sinus aneurysms are reported.1,2 Aortic insufficiency as a complication of single or multiple aortic sinus aneurysms is almost universal, being attributed to weakening and dilatation of the aortic ring by aneurysmal erosion.3 Complete heart block in this case was complicated by periods of ventricular asystole which soon became refractory to the usual modes of therapy, necessitating continual use of the electrical pacemaker for 15 days. Peculiar to the case to be reported here was a References 1. Performed by Drs. F. X. Byron and J. Fields. Eight hours postoperatively spontaneous idioventricular rhythm ensued at a rate of 70. Signs of heart failure diminished. The patient died on Sept. 3, 1955, when a sudden prolonged ventricular asystole did not respond to electrical stimulation. 2. Micks, R. H.: Congenital Aneurysms of All Three Sinuses of Valsalva , Brit. Heart J. 2:63, 1940.Crossref 3. Duras, P. F.: Heart Block with Aneurysm of the Aortic Sinus , Brit. Heart J. 6:61, 1944.Crossref 4. Snyder, G. A. C., and Hunter, W. C.: Syphilitic Aneurysm of the Left Coronary Artery with Concurrent Aneurysm of the Sinus of Valsalva, and an Additional Case of Valsalva Aneurysm Alone , Am. J. Path. 10:757, 1934. 5. Zoll, P. M.; Linenthal, A. J., and Norman, L. R.: Treatment of Stokes-Adams Disease by External Electric Stimulation of the Heart , Circulation 9:482, 1954.Crossref 6. Bellet, S.; Wasserman, F., and Brody, J. I.: Treatment of Cardiac Arrest and Slow Ventricular Rates in Complete A-V Heart Block: Use of Molar and Half Molar Sodium Lactate; a Clinical Study , Circulation 11:685, 1955.Crossref 7. Hufnagel, C. A.; Harvey, W. P.; Rabil, P. J., and McDermott, T. F.: Surgical Correction of Aortic Insufficiency , Surgery 35:673, 1954. 8. Pearce, M. L., and Nordyke, R.: Some Observations on the Effect of Heart Rate Controlled by an External Stimulator in Aortic Insufficiency , Am. J. Med. 22:498, 1957.Crossref 9. Lown, B.; Arons, W. L.; Ganong, W. F.; Vazifdar, J. P., and Levine, S. A.: Adrenal Steroids and Auriculoventricular Conduction , Am. Heart J. 50:760, 1955.Crossref 10. Jones, A. M., and Langley, F. A.: Aortic Sinus Aneurysms , Brit. Heart J. 11:325, 1949.Crossref 11. Venning, G. R.: Aneurysms of the Sinuses of Valsalva , Am. Heart J. 42:57, 1951.Crossref 12. Barnett, C. W.: Failure of Adequate Treatment in Preventing Cardiovascular Syphilis , Stanford M. Bull. 13:234, 1955. 13. Hood, B. J., and Mohr, C. F.: Microscopic Pathological Appearance of the Aorta in Treated and Untreated Patients with Syphilitic Aortitis , Am. J. Syph. 21:177, 1937. 14. Howe, E. G.: Microscopic Pathological Appearance of the Aorta in Treated and Untreated Cases of Syphilitic Aortitis , Am. J. Syph. 27:50, 1943. 15. Webster, B., and Reader, G. G.: Effect of Antisyphilitic Treatment on the Microscopic Appearance of Syphilitic Aortitis , Am. J. Syph. 32: 19, 1948. 16. Sinclaire, H. A., and Webster, B.: Effect of Penicillin Treatment on the Microscopic Appearance of Syphilitic Aortitis , Am. J. Syph. 38:54, 1954. 17. Turner, T. B., and Hollander, D. H.: Studies on the Mechanism of Action of Cortisone in Experimental Syphilis , Am. J. Syph. 38:371, 1954. 18. Koletsky, S.: Congenital Bicuspid Aortic Valves , Arch. Int. Med. 67:129, 1941.Crossref 19. Koletsky, S.: Acquired Bicuspid Aortic Valves , Arch. Int. Med. 67:157, 1941.Crossref

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1957

References