Rupture of right sinus of Valsalva aneurysm into the pulmonary artery.

Rupture of a sinus of Valsalva aneurysm is an uncommon lesion that can occur in any cardiac chamber since the aortic valve occupies a central position in the base of the heart. However, rupture into the pulmonary artery is extremely rare. We describe a case of rupture of an aneurysm of right sinus of Valsalva into the pulmonary artery of a 51-year-old woman. She had been treated by patch closure of a sub-pulmonary ventricular septal defect and aortic valve replacement due to right coronary cusp prolapse 26 years previously. A massive shunt from Valsalva sinus into pulmonary artery indicated the need of radical operation. The defect in the pulmonary artery wall was closed through a pulmonary arteriotomy with a satisfactory outcome. As far as we know, a case of rupture of a sinus of Valsalva aneurysm into pulmonary artery after the previous operation for VSD has not been reported.