A Case Report on Localized Acute Aortic Dissection of the Sinus of Valsalva Associated with a Bicuspid Aortic Valve Diagnosed with the Onset of Acute Coronary Syndrome

Yuuki Sakaguchi＊	Junpei Tokutome＊	Tomohiro Kurashiki＊
Shigeto Miyasaka＊

(Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital＊, Tottori, Japan)

We experienced a rare case of a patient who had a bicuspid aortic valve associated with acute aortic dissection limited to the sinus of Valsalva involving the left main coronary artery and acute coronary syndrome. The patient was a 36-year-old male who was identified as having a congenital bicuspid aortic valve. He visited our emergency room with a chief complaint of acute chest/back pain. He was diagnosed with acute coronary syndrome based on ECG findings and underwent an emergency coronary angiography. This test revealed filling defects at the entrance of the left main coronary artery, with aortic dissection limited to the sinus of Valsalva suspected. Emergency chest contrast-enhanced CT (ECG gated) led to his being diagnosed as having an acute aortic dissection limited to the sinus of Valsalva. After an intra-aortic balloon pump was inserted in order to maintain the coronary blood flow by surgery, emergency coronary artery bypass surgery and a modified Bentall procedure (the Carrel patch method) were carried out. His postoperative course was good and he was discharged home on the 19th disease day.

 

Jpn. J. Cardiovasc. Surg. 51 : 167-171 （2022）

Keywords：bicuspid aortic valve ; localized acute aortic dissection of Valsalva sinus ; acute coronary syndrome