Ruptured Non-Coronary Sinus of Valsalva Aneurysm Into The Right Atrium Presenting with Tricuspid Valve Endocarditis: Diagnostic Pitfall and Surgical Management: A Case Report

A ruptured sinus of Valsalva aneurysm (SVA) rarely accompanies the tricuspid valve endocarditis. A 37-year-old female presented with dyspnea on exertion, Newyork Heart Association (NYHA) class III, and fever. Echocardiography showed a ruptured noncoronary SVA with large vegetation on the tricuspid valve, resulting in severe tricuspid regurgitation. Blood culture was negative, and sputum culture showed heavy growth of Enterobacter cloacae. Initially, the patient was treated with intravenous ceftriaxone and vancomycin for 10 days and then subjected to the surgical repair of the sinus of the Valsalva aneurysm and the tricuspid valve replacement. Post-operative culture examination of valve tissue did not show growth of any organism. Antibiotics were continued for 4 weeks postoperatively, and the recovery period was uneventful. Follow-up echocardiography at 3 months showed no flow across the patch with normal functioning prosthetic tricuspid valve.