Ramírez-Marrero, Miguel ÁngelAlonso Briales, Juan HLópez-Rincón, Francisco2014-09-222014-09-222007-12Ramírez-Marrero MA, Alonso Briales JH, López-Rincón F. Resuscitated sudden cardiac death caused by left main coronary artery compression by an aneurysm of the sinus of Valsalva. European Heart Journal. 2007 ; 28(24):29590195-668Xhttp://hdl.handle.net/10668/1728Clinical vignetteA 49-year-old woman, without known cardiovascular risk factors. Hoarseness of voice caused by a paralysis of left vocal cord. She was admitted to hospital because of acute coronary syndrome, associated to resuscitated cardiac arrest (asystolia documented) without later neurology sequels. Physical examination was anodyne. Echocardiographic study demonstrated a compatible image with a large left sinus of Valsalva aneurysm (SVA) (Panel A) and mild aortic regurgitation. Cardiac catheterization confirmed the presence of left SVA (Panel B) that produced extrinsic compression of the left main coronary artery (Panels C and D). Repair surgery was made by means of closing the aneurysmal orifice with a patch of dacron. Intra-operatory echocardiographic control study found severe aortic regurgitation, so valvular replacement with 19 mm mechanical prosthesis and extension of the valve annulus with patch of dacron was performed, associated with bypass with safena vein graft to left coronary artery. SVA is a very infrequent cardiac anomaly, generally with silent clinical course until it ruptures. Myocardial ischaemia caused by coronary artery compression is unusual. We described the case of a patient diagnosed of left SVA, whose initial clinical manifestation was the appearance of resuscitated sudden cardiac death in the context of an acute coronary syndrome.enVálvula aórticaInsuficiencia de la válvula aórticaPuente de arteria coronariaEnfermedad de la arteria coronariaMuerte súbita cardíacaParo cardíacoImplantación de prótesis de válvulas cardíacasHumanosSeno aórticoMedical Subject Headings::Anatomy::Cardiovascular System::Heart::Heart Valves::Aortic ValveMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Heart Valve Diseases::Aortic Valve InsufficiencyMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Thoracic Surgical Procedures::Cardiac Surgical Procedures::Myocardial Revascularization::Coronary Artery BypassMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Coronary Disease::Coronary Artery DiseaseMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Heart Arrest::Death, Sudden, CardiacMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Cardiac Surgical Procedures::Heart Valve Prosthesis ImplantationMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Prosthesis Implantation::Heart Valve Prosthesis ImplantationMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Anatomy::Cardiovascular System::Blood Vessels::Arteries::Aorta::Sinus of ValsalvaMedical Subject Headings::Anatomy::Cardiovascular System::Blood Vessels::Arteries::Aorta::Sinus of Valsalvaresearch article17644510open access10.1093/eurheartj/ehm2981522-9645