Figure legends
Figure Multimodal imaging and pathological findings.
A and B Transthoracic echocardiography showing a dissecting aneurysm of the sinus of Valsalva involving the interventricular septum.C The two-dimensional and color Doppler comparative focused images of the parasternal long-axis view of the aortic root show low-speed shunting through the ruptured flow into the aneurysm (white arrows). D Three dimensional echocardiography image viewed from the aortic root, showing intimal tears in the sinus (dotted line).E Computed tomography angiography showing a large aneurysm arising from the sinus of Valsalva. F and G Light microscopy examination of the aortic aneurysm showing focal thickening of the arterial intima with fibrous tissue hyperplasia and multiple focal destruction of the medial structure of the artery with chronic infiltration of inflammatory cells, primarily plasma cells ( H&E ×25, ×200, respectively). LV, left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium; AV, aortic valve; Ao, aorta; IVS, interventricular septum; PA, pulmonary artery; Aneu, aneurysm.
Movie clip S1 . Transthoracic echocardiography shows a dissecting aneurysm of the sinus of Valsalva involving the interventricular septum.
Movie clip S2 . The short axis view shows the quadricuspid aortic valve.