Congenital aneurysms of the sinus of Valsalva with dissection into the interventricular septum.

Four cases of congenital aneurysm of sinus of Valsalva (CASV) with rupture and dissection into the intraventricular septum are described. Their incidence (26.6%) in 15 consecutive cases of CASV is unusually high. Only one of these showed secondary rupture into the left ventricle. If these aneurysms remain unruptured, their diagnosis during life is difficult as in the case of other unruptured aneurysms of CASV. The occurrence of conduction abnormalities in young patients should be one of the indications, and 2-D echocardiography would help to arrive at a definite diagnosis and aid in the institution of appropriate surgical treatment.