RESUMO
Ruptured sinus of Valsalva aneurysm (RSOV) is an uncommon cause of high output heart failure. RSOV most commonly opens into the right ventricle followed by the right atrium and non-coronary cusp involvement is relatively uncommon. Infective endocarditis (IE) is a rare cause of RSOV. We report an interesting clinical scenario of IE causing RSOV managed by device closure. A 16-year-old male patient presented to the emergency department with acute chest pain, fever, and engorged neck veins. On cardiorespiratory system examination he had features of left ventricular failure. Blood culture revealed growth of Staphylococcus aureus. Echocardiography and computed tomography aortography confirmed the diagnosis of 9 mm type IV RSOV (non-coronary cusp to right atrium) with vegetation (5 × 6 mm). The patient refused surgery. When there was no apparent visible vegetation after 6 weeks of antibiotic therapy, we proceeded with 12-mm Amplatzer duct occluder II closure of the anatomical defect. Monthly follow up has been uneventful for 6 months. As per our knowledge this is the first ever reported case of documented definitive IE by S. aureus causing Sakakibara and Konno ruptured Type IV RSOV that has been managed successfully by device closure.