PMC5660324_01
2D-TTE and Doppler interrogation show rupture of the wall of the right coronary sinus of valsalva and flow of blood into the right ventricle
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A 2D-TTE showed a large communication between the right SV and the right ventricle outflow tract (RVOT) with left to right shunt (Figure 1).
Angiograms (aortography and CT angiography) show ruptured right sinus of Valsalva aneurysm into the right ventricle
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The configuration of the aneurysm was consistent with the contrast filled sinus demonstrated by aortography, with a normal coronary sinus and a mobile aneurysm protruding into the right ventricle (Figure 2a). The chest computed tomography (CT) scan demonstrated also the presence of a ruptured right SV aneurysm into the right ventricle (Figure 2b).
Surgical views of the ruptured sinus of Valsalva aneurysm into the right ventricle and the interventricular septal defect
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The operative procedure included the closure of the aorto-ventricular communication and the VSD with patches (Figure 3).
Post operative 2D-TTE shows trivial residual communication between the aorta and the right ventricle
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A 2D-TTE showed a normal left ventricular ejection fraction and trivial residual communication between the aorta and the right ventricle (Figure 4).