ABSTRACT

DISCUSSION:

Ruptured Sinus of Valsalva aneurysm is a rare cardiac problem occurring during pregnancy. Our case of Ruptured Sinus of Valsalva aneurysm presented for the first time at 29 weeks of gestation which posed a dual problem for the management. Clinical deterioration of the patient in the presence of hyperdynamic state questioned continuation of pregnancy. However we were able to continue pregnancy till term after a successful Ruptured Sinus of Valsalva aneurysm repair. The lady could have had a normal vaginal delivery if there was no obstetric indication for caesarean section. This is the first case of Ruptured Sinus of Valsalva aneurysm requiring repair during pregnancy with a successful maternal and foetal outcome.

CASE:

A 29 year primigravida with 29 weeks of pregnancy had Ruptured Sinus of Valsalva aneurysm. She had no prior cardiac problem and her pregnancy was uneventful till then. She was stabilized with decongestive therapy and managed conservatively in the intensive care unit. Five days later clinical deterioration mandated an emergency repair which posed a dilemma of continuation of pregnancy. A successful repair was done under cardiopulmonary bypass with ongoing pregnancy. Pregnancy was terminated at 37 weeks in view of foetal growth restriction with oligamnios. She delivered a 2 kg male baby with good APGAR score by elective caesarean section.

INTRODUCTION:

Ruptured Sinus of Valsalva aneurysm is a rare cardiac problem occurring during pregnancy. We describe a case of successful delivery at 37 weeks following repair of Ruptured Sinus of Valsalva aneurysm at 29 weeks of pregnancy. There is little discussion in literature regarding management of this condition at various gestational periods.This is the first case requiring surgical repair during pregnancy with continuation of pregnancy till 37 weeks.