The occurrence of aneurysms of two aortic sinuses, either congenital or acquired, is rare; involvement of a single sinus, although reported with increasing frequency in recent years, remains an uncommon defect. Heart block is routinely cited in textbooks of cardiology as a possible complication of right aortic sinus aneurysms because of their proximity to the atrioventricular node or the bundle of His, yet only two instances of coexisting complete heart block and aortic sinus aneurysms are reported.1,2 Aortic insufficiency as a complication of single or multiple aortic sinus aneurysms is almost universal, being attributed to weakening and dilatation of the aortic ring by aneurysmal erosion.3
Complete heart block in this case was complicated by periods of ventricular asystole which soon became refractory to the usual modes of therapy, necessitating continual use of the electrical pacemaker for 15 days. Peculiar to the case to be reported here was a
KAHN FH, LEE PEARCE M, BORUN ER. Aneurysms of Two Aortic Sinuses: Associated with Aortic Insufficiency, Perforation into the Left Ventricle, and Complete Heart Block with Prolonged Ventricular Arrest. AMA Arch Intern Med. 1957;100(1):126–131. doi:10.1001/archinte.1957.00260070140016
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