Aneurysm of the aortic sinuses with pseudo-coarctation of the aorta.

Aortic sinus aneurysms are uncommon; association with pseudocoarctation has not been previously recognized. Morgan Jones and Langley (1949) in a classic paper reviewed fortythree autopsy proven cases, added four new ones, and divided them into congenital and acquired types: of the total, twenty-five were congenital. Venning (1951) reported three additional cases and Falholt and Thomsen (1953) in describing a case of unruptured congenital right aortic sinus aneurysm diagnosed by retrograde aortography increased the number of congenital sinus of Valsalva aneurysms to thirty-four. Recently, Besabe et al. (1954) reported a case of congenital aortic sinus aneurysm with rupture into the right atrium and embolic gangrene of a foot; at necropsy ulcerated bacterial endocarditis of a bicuspid aortic valve was found. Sixteen cases of unruptured aortic sinus aneurysms have been diagnosed during life by angiocardiography at this centre. Seven were congenital, three associated with coarctation of the aorta (Dubilier et al., 1955), one other with coarctation of the aorta and subacute bacterial endocarditis (Steinberg and Finby, 1955), three with arachnodactyly (Steinberg and Geller, 1955), and nine acquired, due to syphilis (Merten et al., 1955). The seventeenth case of unperforated aortic sinus aneurysm herein reported is unique because of the association with pseudo-coarctation ofthe aorta.