Clinical Manifestations of the Unperforated Aortic Sinus Aneurysm

There are no diagnostic features for the recognition of unperforated aortic sinus aneurysms except for a grade 3 to 4 cardiac murmur. Linear or massive calcifications in the intracardiac portion of the root of the aorta continuous with the linear calcifications of the ascending aorta sometimes occurs in syphilitic aortic sinus aneurysms. Accordingly, a high index of suspicion and angiocardiography are advocated in order to establish the diagnosis during life. Surgical repair of a localized congenital aortic sinus aneurysm through the right atrial approach seems feasible if there are no serious complicating aortic or cardiac lesions. The diffuse unruptured aneurysmal congenital and syphilitic aortic sinus aneurysms are better left alone. If rupture occurs, surgical repair, even though heroic, should be attempted.