Case Report
ECG-Gated High Resolution CT Evaluation of a Ruptured Non-Coronary Sinus of Valsalva Aneurysm Draining into the Right Atrium: A Case Report
Vaisakh Ajith1*, Chandresh Karnavat2 and Shrinivas B. Desai3
1DNB Radiology Resident, Jaslok Hospital and Research Centre, Mumbai, India
2Consultant Radiologist, Jaslok Hospital and Research Centre, Mumbai, India
3Head of Radiology Department, Jaslok Hospital and Research Centre, Mumbai, India
2Consultant Radiologist, Jaslok Hospital and Research Centre, Mumbai, India
3Head of Radiology Department, Jaslok Hospital and Research Centre, Mumbai, India
*Corresponding author:Dr. Vaisakh Ajith, Department of Radiology Jaslok Hospital and Research Centre15, Dr. G. Deshmukh Marg, Mumbai, Maharashtra, India. E-mail Id: vaisakhsrt@gmail.com
Copyright: ©2026 Ajith V, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information: Submission: 26/02/2026; Accepted: 15/04/2026; Published: 18/04/2026
Abstract
Background: Rupture of a sinus of Valsalva aneurysm (SOVA) is an uncommon but potentially life-threatening condition requiring prompt diagnosis and surgical intervention. While echocardiography is often used as an initial screening modality, computed tomography (CT) provides superior anatomical delineation and is invaluable for surgical planning.
Case Presentation: A 41-year-old female presented with rapidly progressive dyspnea and orthopnea with features of cardiac decompensation. ECGgated CT aortography revealed a focal aneurysmal dilatation of the non-coronary sinus of Valsalva with a rupture tract communicating into the right atrium. The aneurysmal sac was seen protruding into the right atrium with indentation of the adjacent tricuspid valve leaflet. Associated right-sided chamber dilatation and signs of pulmonary hypertension were noted. The patient subsequently underwent surgical repair, and intraoperative findings correlated with CT imaging.
Conclusion: ECG-gated CT angiography provides precise localization of the rupture site, delineation of the fistulous tract, and assessment of valvular involvement, thereby playing a crucial role in preoperative planning of ruptured sinus of Valsalva aneurysms.
Case Presentation: A 41-year-old female presented with rapidly progressive dyspnea and orthopnea with features of cardiac decompensation. ECGgated CT aortography revealed a focal aneurysmal dilatation of the non-coronary sinus of Valsalva with a rupture tract communicating into the right atrium. The aneurysmal sac was seen protruding into the right atrium with indentation of the adjacent tricuspid valve leaflet. Associated right-sided chamber dilatation and signs of pulmonary hypertension were noted. The patient subsequently underwent surgical repair, and intraoperative findings correlated with CT imaging.
Conclusion: ECG-gated CT angiography provides precise localization of the rupture site, delineation of the fistulous tract, and assessment of valvular involvement, thereby playing a crucial role in preoperative planning of ruptured sinus of Valsalva aneurysms.
Keywords:Ruptured Sinus of Valsalva aneurysm; ECG-gated CT; CT angiography; Aortic root; Pulmonary hypertension