Real-time observation of ruptured right sinus of Valsalva aneurysm by high speed ultrasono-cardiotomography. Report of a case.

A two-dimensional echocardiographic manifestation of a ruptured right sinus of Valsalva aneurysm is described in this case report. The ultrasono-cardiotomograms demonstrated the aneurysm cut longitudinally and protruding into the outflow tract of the right ventricle. The configuration of the aneurysm was consistent with the contrast medium-filled sinus demonstrated by angiocardiography. In systole, the aneurysmal sinus moved anteroinferiorly together with the aortic wall. The echocardiogram revealed an abnormal two-layered horizontal echo in the right ventricle which showed the aneurysm when the ultrasonic beam passed through the interventricular septum near the aortic root and mitral leaflets. During the operation, the protruding sinus and a small interventricular septal defect in the membranous septum under it were observed through the opened right ventricle. After the closure of the aneurysm, the two-dimensional echocardiogram no longer showed an abnormal configuration.