Sinus of Valsalva aneurysm obstructing coronary arterial flow: case report and collective review of the literature.

One case of unruptured sinus of Valsalva aneurysm causing left coronary artery compression and lethal myocardial infarction in a 39-year old woman is described. In reviewing the literature, 15 previously published cases of sinus of Valsalva aneurysms disturbing coronary flow were found. It is concluded that the mechanism of coronary flow disturbance differs between aneurysms of the left and right sinuses, respectively. The rare congenital aneurysms of the left sinus carry a considerably greater risk of myocardial ischemia than those of the right sinus. The risk of this complication supports an aggressive surgical attitude towards asymptomatic sinus of Valsalva aneurysms.