Transesophageal echocardiographic diagnosis of a ruptured sinus of Valsalva aneurysm with right atrium fistula

Congenital aneurysms of the sinus of Valsalva. are relatively rare, tending to be most frequent in adults. Untreated, there is a substantial risk of c omplication due to bacterial endocarditis and, if rupture occurs, rapid and progressive cardiac insufficiency is fatal at short term. We report the ca se of a 53-year-old mate with a ruptured right sinus of Valsalva aneurysm, resulting in an anomalous right atrium fistula. Symptoms presented, clinica l diagnosis and, above all, transesophageal echocardiography were crucial i n the final diagnosis leading to an early and satisfactory surgical interve ntion. Catheterization and angiography were not definitive. Echocardiograph ic data are described and a bibliography of relevant research articles is p rovided.