Ümit ÖZYURDA, A. Rüçhan AKAR, Zeynep EYİLETEN, Mustafa ŞIRLAK, Refik TAŞÖZ

Aortico-cameral communication from right sinus of valsalva to right atrium

Aortiko-sağ atriyal tünel nadir görülen konjenital anomalidir. Bu vaka takdiminde anstabil anjinası ve fizik muayenede sağ sternal bölgede devamlı üfürümü olan 57 yaşında erkek hasta sunulmaktadır. Koroner anjiyografide üç damar hastalığı ve sağ Valsalva sinüsünden ayrı olarak çıkan anormal bir yapı tespit edildi. Dijital substraksiyon anjiyografide bu yapının sağ atrium çatısıyla ilişkisi olduğu görüldü. Hastamızda, sağ koroner arterden tamamen ayrı olarak, sağ Valsalva sinüsünden başlayıp sağ atriyoventriküler oluğun ön kısmında sonlanan, 5 cm uzunluğunda bir tünel tespit edildi.Yazımızda bu tip doğumsal aorto-atriyal bağlantıların tedavisi tartışıldı.

Sağ valsalva sinüsü ile sağ atriyum arasında aertico-kameral komünikasyon

Aortico-right atrial tunnel (ARAT) is a rare congenital entity. We report a case of 57-year-old man who presented with unstable angina and who had a continuous murmur at the right sternal edge. Coronary angiograpy revealed triple vessel coronary artery disease and a separate anomalous structure arising from the right sinus of Valsalva. Digital substraction angiography was necessary to define the distal end of this connection which was the roof of the right atrium. Our patient is unique in that the tunnel 5 cm in lenght originated from the right sinus of Valsalva and entered the right atrium anteriorly having traversed the right atrioventricular groove anterior, totally separate to the right coronary artery. The management of these congenital aorto-atrial connections is discussed.

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