Sinus of Valsalva aneurysms complicated by infective endocarditis: one rupturing into the left ventricle and the other dissecting into the interventricular septum

Abstract Background: Sinus of Valsalva aneurysm (SVA) is an uncommon cardiac abnormality and can be a serious complication of infection or trauma or after cardiac surgery or a procedure. The clinical features and symptoms are inextricably linked to the progression and site of rupture of the aneurysm.Case presentations: We present two rare cases of ruptured SVA, both of which were associated with infective endocarditis. In one case the SVA ruptured into the left ventricle and in the other case dissected into the interventricular septum.Conclusions: These two cases highlight the expanding clinical view of SVA complicated by infective endocarditis using echocardiography and hemodynamic assessment to guide surgical planning.