Tricuspid regurgitation due to sinus of Valsalva-right heart fistula diagnosed by two-dimensional echocardiography.

The case of a 31-year-old woman with severe right heart failure in the course of bacterial endocarditis and systolic and diastolic murmur at the third left intercostal space is described. Two-dimensional echocardiography showed a vegetation moving from the noncoronary aortic sinus of Valsalva to the right atrium, encroaching upon the septal leaflet of the tricuspid valve. An acquired fistula was confirmed by aortography and surgery. This is an unusual case of tricuspid regurgitation due to acquired aortic sinus of Valsalva-right heart fistula diagnosed by two-dimensional echocardiography.