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Ann Thorac Surg 2006;82:1525-1527
© 2006 The Society of Thoracic Surgeons

Case Reports

Austrian Triad with Sinus of Valsalva Aneurysm and Rupture

John McLean Trotter, MDa, Giorgio Aru, MDb, Ervin R. Fox, MD, MPHa,*

a Department of Medicine, Jackson, Mississippi
b Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi

Accepted for publication January 11, 2006.

* Address correspondence to Dr Fox, Jackson Heart Study, University of MS Medical Center, 2500 North State Street, Jackson, MS 39216 (Email: efox{at}medicine.umsmed.edu).

An interesting case of a young patient presenting with Austrian's Triad: pneumococcal pneumonia, pneumococcal meningitis, and pneumococcal endocarditis. On echocardiogram the patient was noted to have a noncoronary sinus of Valsalva aneurysm and vegetations on the aortic cusps resulting in disruption of valvular integrity and severe aortic insufficiency. Color Doppler also revealed rupture of the aneurysm into the right atrium. The patient was taken to surgery where the noncoronary cusp was noted to be completely replaced with vegetative lesions. The aortic valve was replaced with a No. 21 Carpentier-Edwards bioprosthetic valve (Edwards Lifesciences, Irvine, CA), and the noncoronary sinus of Valsalva was repaired with concomitant closure of the fistula using glutaraldehyde autologous pericardium.






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