case_images: PMC11833493_01
case_images: (A) Electrocardiogram at admission demonstrating complete heart block with a ventricular escape rhythm. (B, C) Transthoracic echocardiography (TTE) in the parasternal long-axis (B) and short axis (C) views, revealing an unruptured sinus of Valsalva aneurysm (white asterisk) protruding into the basal interventricular septum, causing significant compression of the conduction system. (D, E) Contrast-enhanced cardiac computed tomography (CT) images in axial (D) and LVOT (E) planes confirming a 5.1 x 3.3 cm aneurysm (asterisk) originating from the right sinus of Valsalva, extending into the interventricular septum without coronary artery compression. (F) Three-dimensional volume-rendered CT reconstruction visualizing the aneurysm's anatomical relationship with adjacent cardiac structures. (G, H) Intraoperative images showing the aneurysm repair. (G) Exposure of the aneurysm sac during surgery. (H) Surgical closure using an autologous pericardial patch along with aortic valve replacement. (I) Postoperative electrocardiogram demonstrating resolution of the complete heart block, with restoration of sinus rhythm and a right bundle branch block. RCC (right coronary cusp), NCC (non-coronary cusp), Ao (aorta), RV (right ventricle), LV (left ventricle), and LA (left atrium).
case_images: qyaf005f1.jpg
case_images: PMC11833493_01_qyaf005f1.jpg
case_images: qyaf005-F1
case_images: Association Class IV over 1 week following recent chest trauma. An electrocardiogram (ECG) revealed a complete heart block with a ventricular escape rhythm (Figure 1A). C; see Supplementary data online, Video S1). Cardiac computed tomography confirmed a 5.1 x 3.3-cm aneurysm arising from the right sinus of Valsalva, extending into the inter-ventricular septum without compressing the coronary arteries (Figure 1D and E). The patient underwent successful surgical closure using an autologous pericardial patch along with aortic valve replacement (Figure 1G and H). The post-operative course was uneventful, and follow-up ECG demonstrated resolution of the heart block with normalization of sinus rhythm and right bundle branch block (Figure 1I).