A case of a six-year-old girl with an unruptured aneurysm of the sinus Val salva with a left ventricle-right atrium communication is reported. Emphasis is put on the diagnostic value of the echocardiogram, especially for differentiation of the sinus of Valsalva from the aortic cusp and visualization of intracardiac hemodynamics through the shunt. She showed neither cardiac failure nor aortic regurgitation preoperatively. Because rupture was likely to occur, the aneurys mal sac was resected and plicated, and primary surgical closure of the shunt was done. Postoperative echocardiography showed no shunt and sufficient pli cation of the aneurysm.
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