Figure 3 coronary angiogram showed the main trunk and the branch of left coronary artery was clear with no stenosis, the right coronary artery showed slightly stenosis. (LCA, left coronary artery; LAD, left anterior descending artery; LCX, left circumflex artery; RCA, right coronary artery)
In conclusion, the diagnosis was confirmed using multimodality imaging. The final diagnosis was ruptured sinus of Valsalva aneurysm, paravalvular aortic root pseudoaneurysm and interventricular septal dissecting aneurysm. The diagnosis was confirmed intraoperatively, and he underwent the modified Cabrol procedure cardiac surgery, repaired ruptured SOV aneurysm and closured the communication of the pseudoaneurysm with Dacron patching.
On the postoperative follow-up, TTE (Figure 4,Movie s7) demonstrated that the mentioned cystic cavity was separated by a solid component (thrombus organization) and color doppler did not detect communication with aortic artificial blood vessel.One month after operation, TTE was almost impossible to detect the mentioned cystic cavity. The prosthetic aortic valve worked normally and artificial blood vessel kept patency.