We noticed a considerable variability of clinical presentation in our cases, according to the number of the ventricular segments affected by the anomaly. According to our data, middle-term prognosis appears to be better than that previously reported in the literature. We found a reduction of the systolic function only in 50% of cases, all with severe involvement of the apical and postero-lateral segments. Diastolic function was compromised only in those patients with severe impairment of systolic function.

Sinus of Valsalva aneurysm is a rare congenital defect and the diagnosis is usually made after it ruptures. Very few cases of non-complicated sinus of Valsalva aneurysm have been published. The anomaly most often involves the right coronary sinus and less frequently the non-coronary sinus. A case with left sinus of Valsalva has not been reported. Since the aortic valve occupies a central position in the base of the heart, rupture of a sinus of Valsalva aneurysm can occur in any of the four heart chambers. Rupture into the pulmonary artery is very rare and is mostly associated with other congenital cardiopathies.