Surgical repair of ruptured sinus of Valsalva aneurysm with aorto-mitral destruction
Bibliographic record
Abstract
Sinus of Valsalva aneurysms are rare cardiac anomalies with life-threatening potential when ruptured. While most arise from the right coronary sinus and rupture into right-sided chambers, left-sided ruptures are exceptionally uncommon and surgically challenging. We report a 57-year-old male with multiple comorbidities and newly diagnosed stage 4 follicular lymphoma who presented with New York Heart Association class IV heart failure. Imaging revealed a large pseudoaneurysm of the left sinus of Valsalva with perforation into the left atrium and ventricle, disruption of the aorto-mitral curtain, and severe mitral regurgitation. A multidisciplinary team recommended surgery prior to chemotherapy. The operation included a mitral valve repair with autologous pericardial patch, reconstruction of the aorto-mitral curtain, aortic valve replacement, and ascending aortic replacement with a Dacron graft. Post-operatively, the patient developed tamponade, bacteraemia and required prolonged intensive care, but ultimately stabilized and proceeded with lymphoma therapy, and is currently doing well. This case highlights the rarity and complexity of left-sided sinus of Valsalva aneurysm rupture involving multiple cardiac structures. Definitive surgical repair remains the gold standard, and a multidisciplinary approach is essential in optimizing outcomes for high-risk patients with significant comorbidities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".