Severe Aortic Regurgitation due to Unruptured Right Coronary Sinus of Valsalva Aneurysm

A 38-year-old man, who was pointed out systolic and diastolic heart murmur three years before, was visited local hospital because of heart failure. Past medical history was unremarkable. Echocardiography revealed severe aortic regurgitation (AR), and he was transferred to our hospital for pre-operation examination after medical treatment. On admission our hospital, echocardiography showed severe AR due to right coronary cusp prolapse, left ventricle enlargement (80.2mm) and reduced ejection fraction of left ventricle (55%). CT angiography showed unruptured right coronary sinus of Valsalva aneurysm with anomalous origin of the right coronary artery. For this reasons, we diagnosed that severe AR due to unruptured right coronary sinus of Valsalva aneurysm lead to heart failure. We referred the patient to cardiac surgeons to repair aortic valve and sinus of Valsalva aneurysm. To our best knowledge, severe AR due to unruptured coronary sinus of Valsalva aneurysm is rare cause of heart failure. We will report with some other case reports and reviews.