Sinus of Valsalva aneurysm is a rare cardiac anomaly that may be congenital or acquired. The congenital aneurysm which
is more common and is often caused by weakness at the juncture of the aortic media and the annulus fibrosus. Aneurysms
may originate in the right coronary sinus (65-85%), the non-coronary sinus (10-30%), and rarely the left coronary sinus
(1-5%). A 60-year-old adult who presented with congestive heart failure was found to have a ruptured aneurysm of the
left sinus of Valsalva. The aneurysm was opening into the main pulmonary artery, which was demonstrated well by
transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization. The patient was advised
aortic valve replacement but was not willing for surgery and discharged on medical therapy.
Aortopulmonary communication, left sinus of valsalva, sinus of valsalva aneurysm