PMC3461629_01
(a) short-axis echo view. Demonstrating fingerlike protrusion evident of ruptured right coronary sinus of Valsalva aneurysm. (b) Subcostal view. (c) Short-axis view of color compared with color flow doppler evidence of aorta to right ventricle fistulous connection.
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fig2
A transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TTE) demonstrated a fistulous connection between the aorta and right ventricle (Figure 2).
(a) Intraoperative image demonstrating ruptured right sinus aneurysm with visualization of the intact noncoronary cusps. (b) Intraoperative picture demonstrating the 1 cm hole at the junction of the right coronary cusp and at the junction of the right noncoronary commissures. (c) Intraoperative picture after closure of the rupture with bovine pericardium patch.
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fig3
The repair consisted of a bovine patch closure of this hole, excision of the aneurysm and closure of the aorta with multiple layers of prolene (Figure 3).