Right aortic cusp aneurysm causing aortic valve regurgitation with complete heart block

Area of Science:

• Cardiology
• Cardiac Surgery
• Echocardiography

Background:

• Aortic valve aneurysm is a rare condition.
• Complete heart block can be a severe complication of cardiac pathology.
• Aortic regurgitation necessitates timely intervention.

Purpose of the Study:

• To report a rare case of aortic valve aneurysm presenting with complete heart block.
• To discuss the diagnostic approach and management strategy for this condition.

Main Methods:

• Transthoracic and transesophageal echocardiography were used for diagnosis.
• Color Doppler echocardiography assessed aortic regurgitation severity.
• Management included transvenous pacemaker insertion and aortic valve replacement.

Main Results:

• A right cusp aortic valve aneurysm was identified without vegetations.
• Severe acute aortic regurgitation was confirmed.
• The patient developed complete heart block requiring a permanent pacemaker.
• Successful aortic valve replacement was performed.

Conclusions:

• Aortic valve aneurysm can occur without vegetations and lead to severe complications like complete heart block.
• Multimodality imaging is crucial for diagnosis.
• A staged treatment approach involving pacing and valve replacement is effective.