Guess the Most Appropriate Surgical Intervention for This Lady

Case presentation A 27-year-old woman with an underlying ventricular septal defect (VSD) presented with a cough and sudden onset of chest pain. On initial examination, she showed signs of tachycardia, tachypnea, and severe dyspnea.

In addition, a continuous murmur was noted on the auscultation of the anterior chest wall. Vital signs Blood pressure - 98/78 mmHg in the right brachial artery Heart rate – 130 beats per minute Temperature – Afebrile Investigations Electrocardiogram (ECG): Sinus tachycardia and ST depression in V 4 -V 6 leads Chest X-ray: Severe lung congestion and cardiomegaly Transthoracic echocardiography (TTE): Ruptured sinus of Valsalva aneurysm (SVA) connecting to the right ventricle (RV) Sub-arterial VSD measuring 10 × 12 mm , with a left ventricular ejection fraction of 47% Normal valve function with mild tricuspid regurgitation (Figure 1) Lab findings WBC count: 3.1…