Figure1
chest radiograph showing an enlarged heart (A); Thoracic echocardiography and esophageal echocardiography indicated that the right coronary sinus of the aorta expanded to the right ventricular outflow tract, and the continuity was interrupted, aortic valve prolapse. This image shows the aneurysm and its rupture into the right ventricular outflow tract. Color Doppler (white arrow) shows turbulent flow through rupture and regurgitation of the aortic valve (B, C); Intraoperative esophageal ultrasound indicated that after repair, the broken shunt of the sinus tumor disappeared, but moderate to severe eccentric regurgitation occurred in the aortic valve (white arrow, D, E). Exploration revealed that the left coronary lobe of the aortic valve was thin, with rupture and perforation at the root, about 0.3cm in diameter (white arrow, F). Pathological examination of aortic valve showed hyperplasia of fibrous tissue of aortic valve, hyalinosis and mucoid transformation (G, H). Special aortic valve regurgitation mechanism: Rupture of Valsalva aneurysm, Perforation of the leaflet in the bottom area of the LCC, prolapsed NCC and ventricular septal defect(I). NCC, Noncoronary cusp; RCC, right coronary cusp; LCC, left coronary cusp.