Giant Left Sinus of Valsalva Aneurysm with the Occlusion of Left Coronary Ostia in a Syphilitic: A Case Report

Background: Sinus of Valsalva aneurysm (SVA) is a rare anomaly that can be congenital or acquired. Left SVA is an extremely rare condition. Acquired SVA is often associated with infectious aetiologies, including syphilis, bacterial endocarditis, and tuberculosis. We report a rare case of giant left sinus of Valsalva aneurysm with the occlusion of left coronary ostia in a 28-year-old male patient with syphilis. Case presentation: A 28-year-old man present with a 6-month history of chest pain and heart failure. The imaging examination revealed the giant aneurysm originated from the left sinus of Valsalva, but the left coronary artery did not show. In addition, the patient had active syphilis and was being treated with penicillin. The patient was referred for surgery, Bentall procedure was completed with a single anastomosed right coronary artery. Intraoperative observations and pathological examination supported the diagnosis of cardiovascular syphilis. The patient recovered uneventfully and discharged 9 days later. At 36 months of follow-up, there were no coronary events or prosthesis dysfunction. Conclusion : Syphilitic cardiovascular disease included syphilitic aortitis, aortic aneurysms, aortic regurgitation and coronary ostial stenosis, and gummatous myocarditis. The diagnosis of this disease requires a combination of clinical symptoms, imaging examinations and pathological results. Surgery and penicillin are effective treatment options.