Valsalva sinuses

The aortic valve system is composed of three leaflets and three aortic cavities called Valsalva sinuses. The leaflets are the mobile parts of the valve. The sinuses are cavities located behind the leaflets. They establish a junction between the aorta conduit and the left ventricle (see Fig. 16.1). Two sinuses include the entry of the left and right coronary arteries, and are therefore called coronary sinuses. The third sinus is the noncoronary sinus. 

V-Loc 180 wound closure device, 392 vacuum-remelted (VM) process, 304 Valiant devices, 653-6 Valsalva aortic root graft, 454 Valsalva sinuses, 486 Vascufll monofilament, 295 vascular endothelial growth factor (VEGF),467... 

Vagal maneuvers Maneuvers that stimulate the activity of the parasympathetic nervous system and thereby inhibit atrioventricular nodal conduction. Examples of vagal maneuvers include cough, carotid sinus massage, and Valsalva maneuver. 

Aorta A familiar arterial pressure trace. Its systolic component follows the LV trace between points B and C at a slightly lower pressure to enable forward flow. During IVR, closure of the aortic valve and bulging of the sinus of Valsalva produce the dicrotic notch, after which the pressure falls to its diastolic value. 

In Fig. 7 some photographs of flow patterns are illustrated the first shows the flow patterns in the device without the valve and the second the flow patterns of a bioprosthesis while the last two show the flow patterns of a HK and a Sorin tilting disc valves. Without the valve, the flow patterns are rectilinear and parallel to each other and there is no turbulence. With the bioprosthesis the zone of rectilinear flow is smaller, but central the turbulent flow appears only close to the aortic wall. The two mechanical valves show a dissymmetrical flow with a great zone of turbulence over the disc hence their hemodynamics is worse than that of the bioprosthesis. It is interesting to note the presence of vortexes inside the sinuses of Valsalva in all the photographs. Such vortexes are important for the closing mechanics of the natural leaflets ... 

Sheppard MN, Petrou M. Minocycline-induced pigmentation of the aortic valve and sinuses of Valsalva. Arm Thorac Surg 2009 88(5) 1704. 

Possibly Valsalva s maneuver or carotid sinus massage to treat PAT... 

If patient is stable, vagal stimulation, Valsalva s maneuver, and carotid sinus massage or adenosine. 

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