Rupture of aortic sinus valsalva aneurysm and its management

Here, we present successful management of a patient with rupture of right sinus valsalva and ventricular septal defect. Aneurysm of the aortic sinus also known as sinus of valsalva (ASOV) is a rare cardiac defect which can be congenital or acquired. Right coronary sinus (most common) usually ruptures into the right ventricle causing left to right shunt as seen in our patient. Unruptured aneurysms cause obstruction to right ventricular outflow tract. A 29-year-old male patient presented with dyspnea, palpitations, easy fatigability and severe limitation of physical activity. Transthoracic echocardiography showed membranous out pouching of the right coronary cusp (RCC) into the right ventricle. Patient was medically managed with drugs. Under general anaesthesia, after instituting cardiopulmonary bypass (CPB) surgical repair with pericardial patch, closure of subpulmonic ventricular septal defect was performed. Patient vitals were stable after surgery and he was asymptomatic on the first follow-up after discharge.