Five patients were operated on because of ruptured aneurysm of the sinus of Valsalva. In the cases with no concomitant VSD the surgical access from the aorta was used. The aorta was opened and the Fogarty catheter was introduced to the fistula. The "wind sock" of the aneurysm was pulled back to the aorta and excised. The opening was closed with double-line pledgetted polypropylene sutures. In severe aortic incompetence mechanical prostheses were implanted. One patient had bacterial endocarditis with reopening of the fistula and aortic valve incompetence that required reoperation. All patients are in a good clinical state. We recommend the use of Dacron patches even in small aneurysms to avoid re-opening of the fistula.
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