Rupture of a sinus of Valsalva aneurysm. Repair in a 3-month-old infant. Case report

Rupture of a sinus of Valsalva is a fistula connecting an aortic sinus of Valsalva with a cardiac chamber, generally right either the atrium or the ventricle, resulting in L-R shunt that may induce congestive heart failure. The lesion is diagnosed by echocardiogram and early surgery is always granted due to the high risk of complications like congestive heart failure. We present a case diagnosed at birth after normal pregnancy and delivery and normal fetal echocardiograms. At 2 nd day of life, a continuous murmur was evident. Echocardiogram showed a 5mm-diameter tunnel-like structure with pulsatile flow originating from the right sinus of Valsalva and ending at the right atrial appendage. At the age of 3 months, the patient was operated upon. A combined approach was used through the ascending aorta and the right atrium. It consisted on closure of the distal orifice in the atrium and partial resection of the aneurysm wall and suture. Postoperative course was uneventful with normal postoperative echocardiogram. Rupture of a sinus of Valsalva is a rare congenital lesion that may result in significant L-R shunt and congestive heart failure. Surgery restores normalcy preserving aortic valve function and coronary flow. This is the youngest reported case in the literature.(c) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).