Valsalva Sinus Aneurism Associated with Interventricular Septal Defect, Right Medioventricular Stenosis and Bicuspid Aortic Valve

Backgroud: Valsalva sinus aneurysms are abnormalities of the heart that can be acquired or congenital. The most often associated congenital anomaly is interventricular communication which is a predisposing factor to the occurrence of aortic insufficiency. Transcatheter closure has recently emerged as an alternative but surgery still has indications. Aim: We report our experience on the management of this pathology in a subsaharian country. Patient and method: We report the observation of a 7.5-year-old child whose discovery was fortuitous upon exploration of a heart murmur. Results: Doppler echocardiography made the diagnosis possible showing a large under pulmonary interventricular septal defect with a right left shunt, a small non-stenotic sub-aortic membrane, a bicuspid aortic valve without leakage or stenosis, a significant dilation of the aortic root. The surgical management was an intervention according to Tyrone-David technique with closure of the interventricular septal defect. Postoperative outcomes were simple and the short- to medium-term evolution favorable. Conclusion: Depending on the definition used to diagnose valsalva sinus aneurysms, the frequency of this pathology may be underestimated. What seems most appropriate to us is the definition considering the diameter of the sinuses relative to the body surface. An another endpoint is the need to explore the aortic root in the presence of interventricular communication and bicuspid aortic valve.