Echocardiography diagnosis of ruptured aneurysm of sinus of Valsalva. Report of two cases.

Echocardiographic features of two cases of ruptured congenital aneurysm of Valsalva sinus with (case1) and without (case 2) a supracristal ventricular defect were studied before and after surgery by standard echocardiography. M-mode scan and two-dimensional echocardiography. Discontinuity was observed in the echo from the aneurysm wall of the Valsalva sinus in case 1 with ruptured aneurysm, but was not observed in a similar case of unruptured aneurysm. Herniation of the right coronary cusp of the aortic valve into the right ventricular outflow tract was also observed in case 1. After surgical correction the echo from the aneurysm wall and from the herniated right coronary cusp of the aortic valve disappeared. Discontinuity in the echo from the anterior aortic wall and the interventricular septum also disappeared. In case 2, discontinuity in the echo from the anterior aortic wall, and tricuspid flutter with an abnormally low early diastolic peak were observed. These abnormalities disappeared after surgery. The ability of echocardiography to detect ruptured Valsalva aneurysm is discussed.