Patch Repair and Reconstruction of the Left Main Trunk for Isolated Extracardiac Unruptured Left Sinus of Valsalva Aneurysm

Abstract

Here, we report a case of a 67-year-old male who presented to our hospital with a sinus of Valsalva aneurysm (SVA). His history included of hepatectomy resulting from hepatocellular carcinoma, as well as an asymptomatic left SVA discovered approximately two years prior. Computed tomography (CT) indicated SVA expansion and the presence of a new mural thrombus with no evidence of coronary artery compression or aortic valve regurgitation. The SVA was resected, and we repaired the orifices of the SVA and the left coronary artery with a Hemashield patch. We then reconstructed a single coronary artery bypass graft to the left main trunk (LMT) using the great saphenous vein. The patient’s recovery was uneventful after surgery and he was discharged on postoperative day 11. SVA is a rare condition that occurs in 0.1–3% of patients undergoing cardiac surgical procedures, more frequently in the right or noncoronary sinus of Valsalva, making a left SVA exceedingly rare. Our report describes an unusual case of extracardiac unruptured left SVA that we successfully treated with resection, cardiac patching, and reconstruction of the LMT.