An unusual early, childhood presentation in a case with reputured non-coronary sinus of Valsalva aneurysm with Gerbode defect and severe pulmonary hypertension is described. The reasons for early rupture are discussed and anatomically important relations of membranous septum, fibroskeleton of heart and conduction system are schematically elucidated. Associated severe tricuspid and aortic regurgitation are explained to be secondary effects following the rupture of aneurysm. A technique of surgical correction of this rare association of anomalies using single PTFE patch is illustrated, cautiously safeguarding the closely related conduction system. Regurgitant aortic and tricuspid valves were also successfully repaired. In retrospect, early repair before rupture of aneurysm and onset of severe pulmonary hypertension may be more beneficial, which would also prevent the leakage of semilunar and atrioventricular valves.