A 32-Year Experience with Surgical Repair of Sinus of Valsalva Aneurysms

Harkness, James; Fitton, Torin P.; Barreiro, Chris J.; Alejo, Diane; Gott, Vincent L.; Baumgartner, William A.; Yuh, David D.

doi:10.1111/j.0886-0440.2005.200430.x

Cited by 68 publications

(73 citation statements)

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“…The technique is also classified as primary closure (with or without Teflon reinforcement), aortic root replacement (usually associated with severe aortic insufficiency or compromise of more than one Sinus of valsalva) or patch closure (single or double), which prevents aortic valve deformation, reduces stress on the suture line, and optimizes long-term functionality compared to direct closure [9]. Operative mortality is generally low (1%) [1,8] in patients without infection; an Eastern study registered 3.5% mortality [7,11,3]. However, cases of infected Sinus of valsalva aneurysms (endocarditis or sepsis) have 4-5 times greater risk of perioperative death.…”

Section: Discussionmentioning

confidence: 99%

“…Perioperative mortality in patients without an infection is attributed to low cardiac output, especially in patients with cardiac abnormalities that are corrected concomitantly. Recent series have estimated a survival of 5 and 10 years after the correction of Sinus of valsalva aneurysm of 97% and 82%, respectively [1,9]. The prognosis seems to be improved if the aortic valve and aortocoronary bridge replacement can be avoided [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis seems to be improved if the aortic valve and aortocoronary bridge replacement can be avoided [2,4]. Sinus of valsalva aneurysm recurrence per se is rare [1,2]. There is no doubt of the indication of surgical repair for symptomatic Sinus of valsalva aneurysm because this represents a significant risk of death.…”

Section: Discussionmentioning

confidence: 99%

“…Sinus of valsalva aneurysm recurrence per se is rare [1,2]. There is no doubt of the indication of surgical repair for symptomatic Sinus of valsalva aneurysm because this represents a significant risk of death.…”

Section: Introductionmentioning

confidence: 99%

“…Transthoracic echocardiography and transesophageal echocardiogram have a diagnostic accuracy of 75% and 90%, respectively, for ruptured or unruptured Sinus of valsalva and allow discrimination of size, origin of the sinus, point of termination, severity and mechanism of the valvular insufficiency, presence of cardiac or associated vascular abnormalities as well as the orientation of the surgical procedure [6,8,9,14]. Magnetic resonance imaging and Computed tomography offer high diagnostic effectiveness [1,6,8,11,3]. In 1955, the first successful correction of a Sinus of valsalva aneurysm was reported under deep hypothermia without cardiopulmonary bypass [3].…”

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confidence: 99%

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A Large, Unruptured, Aneurysm of Right Sinus of Valsalva, Extending Behind the Main Pulmonary Artery Associated with Bicuspid Aortic Valve-a Rarest Presentation

2016

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Background: Aneurysm of Sinus of valsalva is caused due to lack of the continuity between the middle layer of the aortic wall and aortic valves.Case report: A patient presented with dyspnoea and chest pain. Computed tomographic angiocardiography revealed dysplastic aortic valve and aneurysm of right sinus of valsalva. We presenting here a case with bicuspid aortic valve complicated with aneurysm of right sinus of valsalva. The aneurysm of sinus of valsalva was extracardiac and extending behind the main pulmonary artery and to the left. Computed tomographic angiocardiography revealed dysplastic aortic valve, para valvular aneurysmal sac communicating with aortic root as well as to left ventricle (? Pseudo-aneurysm). Opening of the aneurysm of sinus of valsalva was closed with Dacron patch from inside of the aorta. Aortic valve was replaced with sorin mechanical valve, size 21. Postoperative period was uneventful and patient was discharged on 7th postoperative day in good general condition. Patient is doing well in follow up visits.Discussion: This is associated with other heart defects, Ventricular septal defect in 30-60%, bicuspid valve (10%), and aortic stenosis (6.5%). Sinus of valsalva aneurysm recurrence per se is rare [1,2]. There is no doubt of the indication of surgical repair for symptomatic Sinus of valsalva aneurysm because this represents a significant risk of death. Operative mortality is generally low.Conclusion: This is the rare presentation of the aneurysm of right sinus of valsalva and is first time in literature because of following reasons.a. Aneurysm of sinus of valsalva was originating from the right sinus and was extending behind the main pulmonary artery.b. This was compressing the left anterior descending artery and causing angina like symptoms.c. This was associated with bicuspid aortic valve which is also a rare occurrence (10%) with aneurysm of sinus of valsalva. Case ReportWe presenting here a case of the patient with bicuspid aortic valve complicated with aneurysm of right sinus of valsalva. The aneurysm of sinus of valsalva was extracardiac and extending behind the main pulmonary artery and to the left. A 45 years old Muslim male patient, carpenter by occupation was admitted with chief complaints of shortness of the breath and chest pain for 1 month. He was having orthopnoea and paroxysmal nocturnal dyspnoea and swelling of the feet. His vitals were stable with pulse rate 96/min, blood pressure 130/50 mm Hg, and respiratory rate 14/min. On auscultation S1 was normal and S2 was soft with grade III/VI diastolic murmur in aortic area. Patient was properly investigated. ECG showed sinus rhythm and X-ray chest was showing cardiomegaly. Transthoracic echocardiography showed calcified bicuspid aortic valve, severe aortic regurgitation, grade II mitral regurgitation and that was appeared to be as dissecting flap in ascending aorta with 75% ejection fraction ( Figure 1). Computed tomography chest was domne and it showed large pseudo-aneurysm of right sinus of Valsalva (Figures 2 & 3...

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Section: Discussionmentioning

confidence: 99%