Sinus of Valsalva Aneurysm with Rupturing into the Right Atrium A Case Report and Review of the Literature

Sinus of Valsalva aneurysm accounts for only 1% of congenital cardiac anomalies. Sinus of Valsalva aneurysm can cause aortic insufficiency, coronary artery flow compromise, cardiac arrhythmia, or aneurysm rupture. A 44-year-old male presented with a 3-month history of palpitation and exertional dyspnea. Cardiac auscultation revealed a grade Ⅲ/Ⅵ ”to and fro” murmur along the left sternal border. Electrocardiography showed ventricular bigeminy. Transthoracic and transesophageal echocardiography revealed an aneurysm of the right sinus of Valsalva rupturing into the right atrium. Aortography also confirmed the presence of an aneurysm of the right coronary sinus, extending into the right atrium. The patient underwent open heart surgery to close the ostium of the aneurysm and to suture the right atrial fistula directly. The patient was well upon follow-up after the operation.