{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:15:08Z","timestamp":1754151308547,"version":"3.41.2"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Dissecting aneurysm of the interventricular septum (DAIS) is a rare congenital or acquired anomaly which can have a progressive course. We report a large DAIS incidentally detected by a routine echocardiogram.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n An asymptomatic tricenarian was incidentally detected to a DAIS during a routine pre-operative evaluation. Multimodality imaging with cardiac CT, MRI, and aortic root angiograms confirmed the diagnosis. Work-up for infectious causes like syphilis and inflammatory causes like connective tissue disorders were negative. Patient is planned for surgical repair.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Dissecting aneurysm of the interventricular septum is a rare anomaly with a poor prognosis. The rupture of sinus of Valsalva aneurysm is the most common cause. Infections like syphilis and infective endocarditis, connective tissue disorders (Marfan syndrome and Ehler\u2013Danlos syndrome), autoimmune diseases (Behcet\u2019s disease, ankylosing spondylitis, systemic lupus erythematosus, Takayasu\u2019s arteritis), bicuspid aortic valve with aortopathy, atherosclerosis, surgery, or trauma are the reported causes. Such dissecting aneurysms can have a progressive course, leading to right or left ventricular outflow tract obstructions, severe aortic regurgitation, and rupture into ventricular chambers, portending a grave prognosis. Hence, surgical correction is the norm.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf308","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T14:01:08Z","timestamp":1752501668000},"source":"Crossref","is-referenced-by-count":0,"title":["Large dissecting sinus of Valsalva aneurysm creating a \u2018triple ventricle\u2019 appearance: case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9715-0141","authenticated-orcid":false,"given":"Swasthi S","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1901-5665","authenticated-orcid":false,"given":"Sudipta","family":"Mondal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayakrishnan","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramya","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"2025071813415527400_ytaf308-B1","doi-asserted-by":"crossref","first-page":"ytac019","DOI":"10.1093\/ehjcr\/ytac019","article-title":"Multilobulated sinus of Valsalva aneurysm dissecting into the interventricular septum (DAIS) and rupturing into left ventricle: a case report","volume":"6","author":"Ghosh","year":"2022","journal-title":"Eur Heart J Case Rep"},{"key":"2025071813415527400_ytaf308-B2","first-page":"17","article-title":"Giant unruptured sinus of Valsalva aneurysm with complete heart block","volume":"13","author":"Barik","year":"2016","journal-title":"J Cardiol Cases"},{"key":"2025071813415527400_ytaf308-B3","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S1010-7940(02)00375-5","article-title":"Surgical treatment of dissecting aneurysm of the interventricular septum","volume":"22","author":"Wu","year":"2002","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025071813415527400_ytaf308-B4","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/S0002-8703(49)90947-3","article-title":"Congenital aneurysm of the right anterior sinus of Valsalva (interventricular aneurysm) with spontaneous rupture into the left ventricle","volume":"37","author":"Warthen","year":"1949","journal-title":"Am Heart J"},{"key":"2025071813415527400_ytaf308-B5","first-page":"330","article-title":"Congenital aneurysms of the sinus of Valsalva with dissection into the interventricular septum","volume":"41","author":"Kinare","year":"1989","journal-title":"Indian Heart J"},{"key":"2025071813415527400_ytaf308-B6","doi-asserted-by":"crossref","first-page":"e6191","DOI":"10.1097\/MD.0000000000006191","article-title":"Dissection of the interventricular septum: echocardiographic features","volume":"96","author":"Gu","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"2025071813415527400_ytaf308-B7","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1177\/021849230801600504","article-title":"Surgery for sinus of Valsalva aneurysm: 27-year experience with 100 patients","volume":"16","author":"Yan","year":"2008","journal-title":"Asian Cardiovasc Thorac Ann"},{"key":"2025071813415527400_ytaf308-B8","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/S0003-4975(97)01432-X","article-title":"Aneurysm of sinus of Valsalva dissecting into interventricular septum","volume":"65","author":"Choudhary","year":"1998","journal-title":"Ann Thorac Surg"}],"container-title":["European Heart Journal - 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