Sinus of Valsalva Pseudoaneurysm

A 59-year-old woman presented with exertional dyspnea this past year. She gave no history of cardiac disease or trauma. On examination, a soft systolic ejection murmur was noted at the left sternal border. Her blood pressure was 110/74 mm Hg, and her pulse rate was 84 bpm. The ECG showed a normal sinus rhythm with T-wave inversion in leads II, III, and aVF. Roentgenography of the heart revealed mild cardiomegaly. Two-dimensional transthoracic echocardiography demonstrated a huge cystic mass (9.4×8.3 cm) with a ball-like thrombus next to the aortic root extending into the right …