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and left ventricular dilation with impaired biventricular function (aneurysm area increased from 5.1 cm2 to 7.0 cm2 and LV dilation increased from 5 cm to 6 cm) (Fig. 1, Panel e). Therefore, emergency surgery was performed. Intraoperatively, there was a dilation in right SVA with a cavity that led to the dissected IVS. Panels F, G, and H show intraoperative 3D transesophageal echocardiography findings of aneurysm inlets (Fig. 1, Panels f, g, and h, Video 2). The patient received aortic valve replacement and underwent Dacron patching. Follow-up TTE revealed improved biventricular function (Video 3).

Rapid growth of right sinus valsalva aneurysm dissecting into interventricular septum.