[Unruptured aneurysm of the right sinus of Valsalva: a case report]

A previously healthy and asymptomatic 45-year-old woman was referred for evaluation of a heart murmur and an unusual dilatation in the aortic root. Transthoracic and transesophageal echocardiography, computed tomography, magnetic resonance imaging, and cardiac catheterization revealed an aneurysm with a maximum diameter of 6.0 cm in the right sinus of Valsalva. Aortic regurgitation and stenosis at the right ventricle outflow tract were associated with the aneurysm. Surgery and histological study demonstrated that the sinus of Valsalva aneurysm was enormously dilated with idiopathic degenerative change in the aortic media. The aneurysm was tremendously large compared to any previously reported. Decrease in pressure load during diastole caused by aortic regurgitation probably resulted in the growth of this huge aneurysm without rupture.