Ruptured sinus of Valsalva aneurysm (RSOV) is a less commonly encountered acquired defect that is often related to the underlying congenital deficiency in structural integrity of aortic sinuses in association with other congenital heart diseases. Surgical RSOV repair (SRR) has been traditionally the treatment of choice for symptomatic patients. However, with the advent of modern percutaneous techniques and refinement in hardware device closure is a safe and effective treatment in selected patients. We herein report a case of RSOV device closure related complication in which the continuous intra-procedural electrocardiogram monitoring assisted in rapid identification of the problem that was resolved successfully in a timely fashion.
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