A 41-year-old man was urgently admitted with sudden onset of chest pain. Emergency coronary angiography revealed a large aneurysm of the sinus of Valsalva and reduced blood flow in the left coronary artery. A modified Bentall operation and coronary artery bypass were performed successfully. A large sinus of Valsalva aneurysm should be regarded as a critical problem that could cause coronary insufficiency.
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