case_images: PMC10663329_01
case_images: Two-dimensional transthoracic echocardiographic images (A) long-axis view of the left ventricle showing echo interruption, no echo in the interventricular septum.(white arrow) (B) the short-axis cross-sectional view of the aorta demonstrates a bicuspid aortic valve anomaly. (white arrow) (C) the non-standard pentachamber cardiac section reveals mitral valve eccentric regurgitation. (D) The three-chamber cardiac cross-section reveals the dimension of the orifice. LA, left atrium; LV, left ventricle; MD, Myocardial dissection.
case_images: fcvm-10-1289624-g001.jpg
case_images: PMC10663329_01_fcvm-10-1289624-g001.jpg
case_images: F1
case_images: Transthoracic echocardiography (TTE) revealed a myocardial dissection with a pouch-like protrusion into the right ventricle, interrupted wall echo in the septum and the basal segment of the left ventricular anterior wall, with an adherent hyperechoic structure within (Figure 1).
case_images: Axial position, contrast-enhanced CT imaging reveals the maximum aperture of the sinus of Valsalva aneurysm to be 2.4 cm (black arrow). The myocardial dissection originates from the fused left and right coronary sinuses (asterisk). A bicuspid aortic valve anomaly is evident, with valve leaflet thickening and calcification (white arrow) (C-F) multiPlanar Reconstruction (MPR) exhibits irregular MD, fusion of the left and right coronary sinuses (black arrow), and high-density opacities within the ventricular wall and interventricular septum (white arrow). LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; AO, Aortic; MD, Myocardial dissection; BAV, bicuspid aortic valve.
case_images: fcvm-10-1289624-g002.jpg
case_images: PMC10663329_01_fcvm-10-1289624-g002.jpg
case_images: F2
case_images: The neck of the aneurysm had a diameter of approximately 1.4 cm, and the morphology of the aneurysm was irregular, with localized pushing on the left coronary artery (Figure 2).
case_images: (A) The heart's presentation reveals evident edema. (B) BAV (white arrow) is discernible, accompanied by numerous calcifications on the valve leaflets. Additionally, we observe the occurrence of a sinus aneurysm rupture (asterisk), concomitant with an intraluminal thrombus.
case_images: fcvm-10-1289624-g003.jpg
case_images: PMC10663329_01_fcvm-10-1289624-g003.jpg
case_images: F3
case_images: A longitudinal tear of approximately 2 cm was evident in the aortic sinus, extending all the way to the interventricular septum and the posterior wall of the left ventricle, accompanied by the formation of an intracavitary thrombus (Figure 3).
case_images: After repairing the rupture of the aortic sinus, the myocardial dissection resolved, and the anatomical structure returned to its normal state.
case_images: fcvm-10-1289624-g004.jpg
case_images: PMC10663329_01_fcvm-10-1289624-g004.jpg
case_images: F4
case_images: CT scans revealed a satisfactory anastomosis of the aorta and coronary arteries, while transthoracic echocardiography (TTE) indicated a significant improvement in left ventricular ejection fraction and anterior wall motion (Figure 4).