Extra cardiac unruptured aneurysm of the right sinus of Valsalva with aortic regurgitation and right coronary ostial stenosis; report of a case

A 78-year-old female presented with a chief complaint of palpitations. She was diagnosed with a large unruptured aneurysm of the sinus of Valsalva accompanying aortic regurgitation and right coronary artery ostial stenosis. When the aneurysm was resected following cardiac arrest, it was found to be an aneurysm with the right Valsalva sinus at the orifice. Root replacement was not required because there was no aortic annular dilatation. Patch closure as well as aortic valve replacement were conducted. The right coronary artery was diverged from the aneurysm and the aperture thereof was severely stenosed. Therefore, bypass surgery was additionally conducted. Postoperative course was uneventful. An unruptured aneurysm of the sinus of Valsalva, which is a relatively rare disease, is asymptomatic in many cases and tends to have grown large when found. Because the postoperative results were relatively good, we believe that surgery should be performed at an early stage in order to avoid rupture.