<p><b>OBJECTIVES</b>To summarize the experience of surgical repair of ruptured sinus of Valsalvaaneurysm to right atrium and to compare the difference between through right atrium repair and transaortic combined with right atrium approach.</p><p><b>METHODS</b>Between January 2004 and December 2009, 53 patients with ruptured sinus of Valsalvaaneurysm to right atrium underwent surgical repair. There were 35 male and 18 female, aged from 15 to 63 with a mean of (33 ± 9) years. Repair through right atrium had undergone in 40 patients (group I), while transaortic combined with right atrium approach in 13 patients (group II). Surgical results between the two group and group were compared in cardiopulmonary bypasstime, clamp aortatime, mechanical ventilationtime, ICU time and postoperative stay time.</p><p><b>RESULTS</b>There were no significant differences between two groups in cardiopulmonary bypasstime [(86 ± 29) min vs. (96 ± 30) min], clamp aortatime [(59 ± 29) min vs. (71 ± 25) min], mechanical ventilationtime [(9 ± 4) h vs. (16 ± 23) h], ICU time [(35 ± 23) h vs. (35 ± 23) h], postoperative stay time [(7.1 ± 0.9) d vs. (7.7 ± 2.8) d] (P > 0.05). Follow-up was performed from 1 to 64 months, with a mean of (32 ± 21) months. There was no death during follow up. One needed operation due to severe aortic valve regurgitation. One combined with coronary artery disease used medication. Heart function (NYHF) of the other patients were I and II degree during follow up.</p><p><b>CONCLUSIONS</b>Surgical repair of ruptured sinus of Valsalvaaneurysm to right atrium shows good result. There is no significant difference between through right atrium repair and transaortic combined with right atrium approach.</p>