Video 4_Case Report: Zero-fluoroscopy retrograde transcatheter closure of a ruptured Sinus of valsalva guided by transesophageal echocardiography.mov

Although surgery remains the primary intervention, transcatheter closure has emerged as a less invasive alternative in suitable patients. However, zero-fluoroscopy retrograde transcatheter closure of RSOV under echocardiography guidance alone is extremely rare.</p>Case presentation<p>A 31-year-old man with a history of hypertension presented with symptoms of atypical chest pain and exertional dyspnea.

Heart auscultation showed a grade III/VI with a to-and-fro murmur. Pre-procedural transthoracic and transesophageal echocardiography (TTE and TEE) demonstrated a ruptured aneurysm from the right coronary cusp of the sinus of Valsalva with shunting into the right atrium. The defect measured 7 mm at the aortic end and 6 mm at the right atrial end, with a distance of 16.5 mm from the right coronary ostium and no significant aortic regurgitation.