# Aneurysmal Cavity in the Interventricular Septum by the Rupture of the Right Sinus of Valsalva: An Interesting Finding on Cardiac Imaging

## TL;DR

A rare case of a ruptured right sinus of Valsalva aneurysm forming a cavity in the heart's septum is documented, emphasizing the role of advanced imaging in diagnosis and treatment.

## Contribution

This report presents a rare case of RSOV aneurysm rupture into the interventricular septum, highlighting unique diagnostic and surgical challenges.

## Key findings

- A ruptured right sinus of Valsalva aneurysm formed an aneurysmal cavity in the interventricular septum.
- Transesophageal echocardiography and CMR were crucial for diagnosis and surgical planning.
- Postoperative complications included complete heart block managed with cardiac resynchronization therapy.

## Abstract

This case report documents a rare congenital anomaly in a 27-year-old man of African descent presenting with exertional chest discomfort and shortness of breath, diagnosed with a ruptured right sinus of Valsalva (RSOV) aneurysm dissecting into the interventricular septum (IVS), creating an aneurysmal cavity. Such occurrences are typically rare, with this type of aneurysm largely manifesting in the right atrium, making its presentation in the IVS without intracardiac communication exceptionally uncommon. Cardiac imaging, including transesophageal echocardiography and cardiac magnetic resonance imaging (CMR), played pivotal roles in visualizing the structural abnormality and planning the subsequent surgical intervention. The patient's treatment included heart failure optimization, followed by surgery to repair the aneurysmal cavity while preserving the native aortic valve. Postoperative challenges included a complete heart block managed by cardiac resynchronization therapy and an intracardiac defibrillator. The report underscores the importance of advanced imaging in diagnosing and managing rare cardiac anomalies, highlighting the aneurysm's unique rupture pattern and location.