Right Sinus Valsalva Aneurysm Ruptured Into the Right Ventricular Outflow Tract

Aortic sinus aneurysm rupture is a rare event (<1% of congenital cardiac lesions); however, it varies geographically and by population. A 56-year-old man presented with symptoms of heart insufficiency and chest pain. Transthoracic echocardiography showed a blow passage between the right coronary sinus and the right ventricular outflow tract. Surgical closure was performed according to the heart team decision. We report a ruptured aneurysm of the right sinus Valsalva that likely developed after surgical trauma to the aortic root during ventricular septal defect closure in childhood. The communication with the right ventricular outflow tract is relatively uncommon. The literature offers valuable insights, mainly from major cohorts and long-term follow-ups, frequently describing fistulas from the aortic root to the right atrium, but rarely to the right ventricular outflow tract. Rupture of the sinus of Valsalva is rare but potentially fatal without prompt diagnosis. Timely, multidisciplinary care is crucial for optimal outcomes.