{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:17:57Z","timestamp":1777393077831,"version":"3.51.4"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sinus of Valsalva aneurysms (SVAs) are rare cardiac anomalies often occurring with co-existing cardiac lesions, such as ventricular septal defects and aortic regurgitation. While often asymptomatic, SVAs can lead to severe complications, including rupture, aortic regurgitation, and dissection. Carotid aneurysms are also uncommon and pose a significant stroke risk if left untreated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of a 56-year-old woman who initially presented with a pulsatile right neck mass and was diagnosed with a right internal carotid artery aneurysm. Subsequent imaging revealed a 45\u2005mm left-sided sinus of Valsalva aneurysm (SVA) and a concomitant coronary artery fistula involving the right coronary artery. She underwent staged surgical management with a modified Bentall procedure and later excision of the carotid aneurysm. Post-operative recovery was uneventful. Genetic testing later confirmed a diagnosis of Marfan's syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>SVAs originating from the left coronary sinus are exceedingly rare, but their potential for fatal complications demands early intervention. This case demonstrates that surgical repair of the left SVA, associated coronary fistula, and carotid aneurysm is both safe and effective, and it reinforces the role of genetic testing in patients with atypical presentations of aneurysmal disease. Multimodal imaging and a multidisciplinary approach are essential in guiding treatment decisions in such unusual presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf508","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:08:22Z","timestamp":1759320502000},"source":"Crossref","is-referenced-by-count":1,"title":["Case report: a rare case of left-sided sinus of Valsalva aneurysm with concomitant coronary artery fistula and carotid artery aneurysm"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5466-1118","authenticated-orcid":false,"given":"Marsioleda","family":"Kemberi","sequence":"first","affiliation":[{"name":"Barts and the London Medical School, Queen Mary University of London , Mile End Road, London E1 4NS ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gentjan","family":"Jakaj","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, King's College Hospital , Golden Jubilee, London SE5 9RS ,","place":["UK"]},{"name":"Heart, Vascular and Thoracic Institute, Cleveland Clinic , 33 Grosvenor Place, London SW1X 7HY ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Stratton","sequence":"additional","affiliation":[{"name":"General Practice Institute, Cleveland Clinic , 33 Grosvenor Place, London SW1X 7HY ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daryll","family":"Baker","sequence":"additional","affiliation":[{"name":"Heart, Vascular and Thoracic Institute, Cleveland Clinic , 33 Grosvenor Place, London SW1X 7HY ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf","family":"Wendler","sequence":"additional","affiliation":[{"name":"Heart, Vascular and Thoracic Institute, Cleveland Clinic , 33 Grosvenor Place, London SW1X 7HY ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"2025102804112894700_ytaf508-B1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/clc.22359","article-title":"Sinus of Valsalva aneurysms: review of the literature and an update on management","volume":"38","author":"Weinreich","year":"2015","journal-title":"Clin Cardiol"},{"key":"2025102804112894700_ytaf508-B2","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/0002-8703(87)90193-1","article-title":"Aneurysm of the sinus of Valsalva: a roentgenologic study of 105 Chinese patients","volume":"114","author":"Guo","year":"1987","journal-title":"Am Heart J"},{"key":"2025102804112894700_ytaf508-B3","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.21037\/jtd-20-2682","article-title":"Surgical management for unruptured sinus of Valsalva aneurysms: a narrative review of the literature","volume":"13","author":"Nguyen","year":"2021","journal-title":"J Thorac Dis"},{"key":"2025102804112894700_ytaf508-B4","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1093\/eurheartj\/ehx452","article-title":"Aneurysmal left sinus of Valsalva in Marfan\u2019s syndrome","volume":"39","author":"Chamsi-Pasha","year":"2018","journal-title":"Eur Heart J"},{"key":"2025102804112894700_ytaf508-B5","first-page":"1248","volume-title":"Rutherford\u2019s Vascular Surgery and Endovascular Therapy","author":"Bush","year":"2018","edition":"9th ed"},{"key":"2025102804112894700_ytaf508-B6","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":"2025102804112894700_ytaf508-B7","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1093\/eurheartj\/ehae179","article-title":"2024 ESC guidelines for the management of peripheral arterial and aortic diseases","volume":"45","author":"Mazzolai","year":"2024","journal-title":"Eur Heart J"},{"key":"2025102804112894700_ytaf508-B8","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1177\/1591019916659262","article-title":"Neurovascular manifestations of connective-tissue diseases: a review","volume":"22","author":"Kim","year":"2016","journal-title":"Interv Neuroradiol"},{"key":"2025102804112894700_ytaf508-B9","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/j.jvs.2011.12.054","article-title":"Presentation and management of carotid artery aneurysms and pseudoaneurysms","volume":"55","author":"Garg","year":"2012","journal-title":"J Vasc Surg"}],"container-title":["European Heart Journal - 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