Surgery following Extracorporeal Cardiopulmonary Resuscitation in a Patient with an Extracardiac Rupture of Valsalva Sinus Aneurysm.

The rupture of sinus of Valsalva aneurysm (SVA) into the pericardial cavity is extremely rare and fatal. A 52-year-old man presented with an abrupt onset of chest pain and dizziness. An echocardiography and a computed tomographic angiography revealed a giant aneurysm of the noncoronary sinus (NCS) (maximum, 70 mm) and pericardial effusion in favor of tamponade with a moderate degree of aortic insufficiency. On the way to the operating room, he suffered cardiac arrest, and extracorporeal cardiopulmonary resuscitation (ECPR) was initiated immediately. While he was prepared for surgery, the patient was supported by extracorporeal life support (ECLS) until cardiopulmonary bypass (CPB) was initiated. The sinus defect was reconstructed using a Dacron patch, followed by resection of the aneurysm. ECLS and CPB were discontinued successfully in the operating room. This study reports a case of an extracardiac rupture of SVA and the successful completion of surgery following ECPR.