Unruptured congenital aneurysm of the sinus of Valsalva presenting with pulmonary stenosis

Congenital aneurysm of the sinus of Valsalva is a rare cardiovascular anoma ly. It is usually silent until rupture occurs. The natural history of unrup tured aneurysm of the sinus of Valsalva is still not clear, and the therape utic strategy is uncertain. Here we reported a case of unruptured aneurysm of the sinus of Valsalva which was correctly diagnosed before invasive diag nostic procedures. A 30-year-old female noted mild palpitation and dyspnea for 1 month. Physically, a grade 3/6 systolic ejection murmur at upper left sternal border was detected, Echocardiography revealed dilatation and irre gular protrusion of the right sinus of Valsalva encroaching on right ventri cular outflow tract to cause obstruction. With these findings, unruptured a neurysm of the sinus of Valsalva with pulmonary stenosis was diagnosed. Car diac catheterization and angiography confirmed the diagnosis. The aneurysm was repaired with a Dacron patch with good results. It is concluded that si nus of Valsalva aneurysm can be diagnosed by echocardiography before its ru pture so as to render a proper management for this potentially life-threate ning anomaly. (C) 1999 Wiley-Liss, Inc.