RSOV aneurysm is a rare but potential cause of high output heart failure, with the reported incidence of 1-5% and male to female ratio of 4:1. It commonly originates in right coronary sinus followed by non-coronary sinus and ruptures into the right ventricle followed by right atrium. The most common coexisting cardiac anomaly with RSOV is Ventricular septal defect in 75% of cases and Aortic Regurgitation in 25%of cases. We are presenting here a case of RSOV aneurysm associated with VSD and ruptured into the right ventricle.
A 43yr old male patient came with complaints of chest pain in the past 6 months associated with shortness of breath on exertion NHYA CLASS II. Known case of chronic calcific pancreatitis. on General examination the patient is moderately built, nourished, pedal edema and Icterus present. on Systemic examination CVS -pan systolic murmur present, RS -NVBS, P/A soft, CNS-NAD. 2Decho revealed -5.7MM RSOV and RV with left to right shunt, gradients-115mm of HG. EF:60%, coronary angiogram revealed normal coronaries. LFT -raised bilirubin (TB-2.9, DB-1.8), serum albumin 2.5. Based on the examination and investigations patient was diagnosed as RSOV aneurysm.
Patient was taken up for RSOV repair Surgery. Under General Anaesthesia on cardiopulmonary bypass. RSOV And Sub aortic VSD
were identified and closed with separate piece of pericardial patch with 5-0 prolene. RVOT part of RSOV is closed with 5-0 Prolene continuous stitch.
Post operatively patient was on inotropic supports which was weaned off gradually. Post op 2D Echo suggestive of no residual shunt across the
patch on 5th post op day patient was discharged with stable hemodynamics. Patient is doing good and on regular follow up.
