Peratrial Device Closure of Ruptured Sinus of Valsalva Aneurysm Into Right Atrium.

An alternative peratrial device closure technique for ruptured sinus of Valsalva aneurysm into the right atrium under exclusive transesophageal echocardiographic guidance is presented. The ruptured site was occluded with a hollow probe-assisted delivery system through a fourth intercostal mini-incision. The peratrial approach provided perfect alignment and positioning for device deployment to avoid device impingement on the aortic valve. This technique may help a certain number of patients, especially those patients with a prior history of radiocontrast media allergy.