Fritz, Ashley VBoles, Kathryn SMartin, Archer Kilbourne2019-12-022019-12-022018-07Fritz Ashley V, Boles Kathryn S, Martin Archer Kilbourne . Echocardiographic evaluation of aorta to right atrial fistula secondary to ruptured sinus of valsalva aneurysm. Annals of Cardiac Anaesthesia. 2018 Jul; 21(3): 313-3140971-9784http://imsear.searo.who.int/handle/123456789/185741We present the case of a 37 year old male who presented with new onset dyspnea, tachycardia, palpitations, and chest tightness. His initial work up demonstrated a dilated pulmonary artery with reflux of contrast dye in to the IVC. Transthoracic echocardiogram identified a “windsock” appearance indicating Sinus of Valsalva aneurysm (SVA) and severe aortic regurgitation. As a result, the patient was taken for emergent surgery where the windsock tissue was surgically repaired with bovine pericardial patch. This case illuminates the uncommon occurrence of SVA and the ability to recognize these findings on multiple imaging modalities including transthoracic, transesophageal two and three dimensional echocardiography as well as direct surgical field visualization.Coronary to atrial fistulaemergency cardiac surgerythree dimensional echocardiographytransesophageal echocardiographyJournal ArticleIndiaDivision of Cardiothoracic Anesthesiology, Mayo Clinic Florida, Jacksonville, FL, USA