INTRODUCTION
Aorto-Right Ventricular Fistula (ARVF) is a very rare condition which communicates the ascending aorta to the cavity of the right ventricle[1–4]. The Sinus of Valsalva fistula was first described in 1839 and has a general incidence about 0.14% to 0.96% of all cardiac operations[3]. The structure most frequently involved is the right coronary sinus, accounting for 64%, followed by the noncoronary sinus[1]. It’s known that the perforation often communicates the aorta to the right ventricle, but it can also do, rarely, to the right atrium, left chambers or even to pericardium[1,5].
This condition is mostly like associated to ruptured aneurysm of Sinus of Valsalva, complication of endocarditis, chest trauma, aorta dissection or complication of another cardiac procedures as valve replacement, Ventricular Septal Defect (VSD) correction and Transcatheter Aortic Valve Replacement (TARV), among others[2,6,7]. This case describes an adult with ARVF without any of these causes above and with no other abnormalities on the aortic valve and root, ascending aorta or ventricular septum.