We present the case of a 37 year old male who presented with new onset dyspnea, tachycardia, palpitations, and chest tightness. His initial work up demonstrated a dilated pulmonary artery with reflux of contrast dye in to the IVC. Transthoracic echocardiogram identified a “windsock” appearance indicating Sinus of Valsalva aneurysm (SVA) and severe aortic regurgitation. As a result, the patient was taken for emergent surgery where the windsock tissue was surgically repaired with bovine pericardial patch. This case illuminates the uncommon occurrence of SVA and the ability to recognize these findings on multiple imaging modalities including transthoracic, transesophageal two and three dimensional echocardiography as well as direct surgical field visualization.

Oropharyngeal stenosis can manifest as a rare complication after surgery for obstructive sleep apnea or tonsillectomy. Scar tissue formation from oropharyngeal stenosis may impede tracheal intubation or laryngeal mask airway insertion. We report the case of an asymptomatic adult woman found to have oropharyngeal stenosis after induction of anesthesia and discuss the management of this challenging scenario. We also contrast oropharyngeal stenosis with nasopharyngeal stenosis, another rare complication of uvulopalatopharyngoplasty.