English K. Diagnosis and treatment options for sinus of Valsalva aneurysms: A narrative review. World J Cardiol 2025; 17(6): 102722 [DOI: 10.4330/wjc.v17.i6.102722]
Corresponding Author of This Article
Kevan English, MD, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, 42nd and Emile Street, Omaha, NE 68198, United States. keenglish@unmc.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jun 26, 2025; 17(6): 102722 Published online Jun 26, 2025. doi: 10.4330/wjc.v17.i6.102722
Diagnosis and treatment options for sinus of Valsalva aneurysms: A narrative review
Kevan English
Kevan English, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE 68198, United States
Author contributions: English K wrote the original draft, contributed to conceptualization, writing, reviewing, and editing. The author has read and approved the final version of the manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kevan English, MD, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, 42nd and Emile Street, Omaha, NE 68198, United States. keenglish@unmc.edu
Received: October 28, 2024 Revised: March 11, 2025 Accepted: May 13, 2025 Published online: June 26, 2025 Processing time: 236 Days and 7.6 Hours
Abstract
Sinus of Valsalva aneurysm (SoVA) is a rare cardiac defect that may be congenital or acquired. It is characterized by abnormal dilatation of the aortic root due to a weakened elastic lamina at the junction of the annulus fibrosus and the aortic media. SoVAs are present in approximately 0.09% of the general population and comprise up to 3.5% of all congenital cardiac defects. It is usually found incidentally on cardiac imaging, with a higher incidence observed in the Western populations and a male-to-female ratio of 4:1. A transthoracic two-dimensional echocardiogram is the initial diagnostic test of choice, which may reveal the characteristic “windsock deformity” that clinches the diagnosis. Other imaging modalities, such as transesophageal echocardiography and cardiac computed tomography angiography, help provide more extensive details of the aneurysm and its adjacent structures. Management options for ruptured and unruptured SoVA include surgical repair or transcatheter closure, which serves as a game-changing development in treatment. This article aims to provide background information on the epidemiology, pathophysiology, diagnosis, and recent advancements over the past decade in the management of SoVAs.
Core Tip: Sinus of Valsalva aneurysm is a rare cardiac defect defined as an abnormal dilatation of the aortic root. This arises due to a weakened elastic lamina at the junction of the annulus fibrosus and the aortic media. Echocardiography is the first-line imaging of choice for diagnosis. Definitive management includes surgery. However, transcatheter closure is a newer minimally invasive technique that is now increasingly preferred over traditional surgical approaches in the treatment of both ruptured and unruptured aneurysms.
