Repair of Ruptured Sinus of Valsalva Aneurysm: Rare Cause of Acute Onset Congestive Heart Failure in Down’s Syndrome

A 20-year-old boy with Down´s syndrome presented to the emergency department with new onset acute heart failure. Right side chest effusion and cardiomegaly was observed on chest x-ray. A mobile aneurysmal sac protruding into the right atrium was detected and a ruptured aneurysm of the right coronary sinus of Valsalva was observed in transthoracic echocardiogram. Cardiac angiography catheterization confirmed the diagnosis. Surgical repair consisting of aneurysm resection and defect closure was performed shortly after with pericardium reinforced suture through the right atrium. The patient was discharged uneventfully.