Percutaneous closure of ruptured sinus of valsalva aneurysm and atrial septal defect

Ruptured sinus of Valsalva aneurysm (SOVA) is a rare albeit well-described entity and coexisting defects like ventricular septal defect, aortic regurgitation and, infrequently, atrial septal defect (ASD) have been reported. Until recently, open surgical closure with cardiopulmonary bypass was the mainstay of treatment. However, transcatheter closure of isolated ruptured SOVA defects has been encouraging. We report percutaneous closure of ruptured noncoronary SOVA to the right atrium and a coexisting secundum ASD with deficient aortic margin. Our experience suggests that successful percutaneous closure of ruptured SOVA and coexisting ASD is a safe alternative to open surgery with satisfactory mid-term follow up.