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Updated: Jul 12, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Unruptured sinus of Valsalva aneurysm in an asymptomatic patient
Subhash Banerjee1, Dinesh H Jagasia
1Department of Internal Medicine, Division of Cardiology, Veterans Affairs Medical Center and University of Iowa Hospitals and Clinics, Iowa City 52246, USA. banerjees@mail.medicine.uiowa.edu
Abstract:
A 75-year-old asymptomatic male patient was referred for transesophageal echocardiography after detection of a diastolic murmur on routine physical examination and widened mediastinum on a chest radiograph. Transesophageal echocardiography revealed a large, unruptured sinus of Valsalva aneurysm, filled with a thrombus and spontaneous echocontrast and protruding into the right atrium. Unruptured sinus of Valsalva aneurysms are rare, frequently asymptomatic, and not associated with any physical findings. The diagnosis was made by transesophageal echocardiography and was confirmed by angiography and at surgery. The need for corrective surgery of asymptomatic, incidentally diagnosed sinus of Valsalva aneurysm is not well defined in the absence of precise knowledge of its natural history. We provide a description of the natural history and rationale for early corrective surgery of sinus of Valsalva aneurysms in asymptomatic patients.
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