The Ball‐Valve Mechanism: Multimodality Imaging of Dynamic Tricuspid Obstruction From a Migratory Ruptured Sinus of Valsalva Aneurysm

This manuscript presents a rare case of a ruptured non‐coronary sinus of Valsalva aneurysm into the right atrium, forming a giant migratory sac that caused dynamic tricuspid valve obstruction via a diastolic ball‐valve mechanism. Transthoracic echocardiography raised the initial suspicion, cardiac computed tomography excluded dissection and visualized its mobility, and transesophageal echocardiography definitively characterized the rupture site and captured the real‐time obstructive pathophysiology. This multimodality imaging approach was pivotal in guiding urgent surgical intervention.