Key result
Valve-sparing root repair successfully treats late thrombosed sinus of Valsalva aneurysm after aortic valve replacement.
Why the study?
Acquired sinus of Valsalva aneurysm (SOVA) is a rare post-surgical complication that is often asymptomatic, though blood stasis within the aneurysmal sac can rarely result in thromboembolic events.
Case Report (n=1)
No
Acquired sinus of Valsalva aneurysm with thrombosis is a rare, late complication of surgical aortic valve replacement that can cause cardioembolic stroke despite lifelong warfarin anticoagulation, highlighting the diagnostic role of multimodal imaging and the feasibility of open valve-sparing root repair.
Background Acquired sinus of Valsalva aneurysm (SOVA) is a rare post-surgical complication that is often asymptomatic but can lead to various complications, including fistulas, heart failure, and rupture. In rare cases, blood stasis within the aneurysmal sac can also result in thromboembolic events. Case Summary We report a case of thrombosed SOVA diagnosed a decade after surgical aortic valve replacement. Despite lifelong anticoagulation with warfarin, the patient experienced multiple transient ischemic attacks culminating in a major ischemic stroke. Multimodal imaging revealed an acquired SOVA with interval resolution of a previously identified intraluminal thrombus. Fortunately, she achieved complete symptom resolution and underwent successful open valve-sparing root repair. Discussion This case highlights SOVA as an uncommon yet important and treatable post-surgical complication and etiology of cardioembolic stroke. It also underscores the potential for delayed clinical sequelae from acquired SOVA, even years after surgery. Finally, it emphasizes the value of multimodal imaging for timely diagnosis of such abnormalities.
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Kalidas et al. (2026) conducted a case report in Cardioembolic stroke from acquired sinus of Valsalva aneurysm (SOVA) thrombosis post-surgical aortic valve replacement (n=1). Open valve-sparing root repair was evaluated on Symptom resolution and successful surgical repair. Open valve-sparing root repair successfully treated an acquired thrombosed sinus of Valsalva aneurysm causing stroke 10 years post-aortic valve replacement in 1 patient.
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