In a normal heart, the typical path of blood flow is to shunt from right-to-left allowing for blood to leave the deoxygenated right system and become oxygenated in the left system. In patients with an aneurysm of the<unk>  of valsalva, the typical path of blood flow is disrupted by the presence of the aneurysm. This can result in blood shunting from left-to-right. The severity of circulatory complications depends largely on the size of the aneurysm and any accompanying defects. The larger the defect, the greater the amount of mixing between deoxygenated and oxygenated blood.
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