sinus of valsalva rupture with dissection into the interventricular septum
a 27-year-old previously healthy woman presented with a 3-month-long history of dyspnea after a nonspecific flu-like illness. congestive heart failure was diagnosed clinically and confirmed radiographically. a transthoracic echocardiogram demonstrated rupture of the sinus of valsalva with dissection into the interventricular septum (figures 1 and 2). severe early diastolic regurgitation into the false, noncommunicating cavity was observed within the septum, as well as moderate left ventricular chamber dilatation, distortion of the anteromedial papillary muscle, and consequent severe mitral regurgitation. a transesophageal echocardiogram showed the site of the rupture with flow into the false cavity (figure 3, a and b). these findings were confirmed on magnetic resonance imaging (mri； figure 4). the patient was stabilized medically and underwent surgical repair. the postoperative transesophageal echocardiogram demonstrated elimination of the regurgitation into the false cavity and decreased mitral regurgitation (although still moderate) and a much smaller aneurysmal sac.
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