Rupture of sinus of valsalva – A 15 years single institutional retrospective review: Preoperative heart failure has an impact on post operative outcome?

Abstract

Background: We reviewed our experience with ruptured sinus of Valsalva aneurysms (RSOV) to determine a correlation with preexisting heart failure (HF) and coexisting cardiac lesions (aortic regurgitation [AR] and ventricular septal defect [VSD]) to postoperative left ventricular (LV) dysfunction and postoperative outcomes. Materials and Methods: Retrospective review of RSOV cases over 15 years showed that RSOV repair was done in 87 patients. We looked for patients who presented with HF and patients having AR and/or VSDs. Statistical analysis was done to see if the coexisting lesions and preoperative HF were associated with postoperative LV dysfunction. Chi-square test was used on contingency table for statistical analysis. Complications in the postoperative period and prolonged Intensive Care Unit stay were noted. Results: 17% (15/87) presented with HF. Fifty-two patients had moderate to severe AR and 50 patients had VSD. Seventeen patients had postoperative LV dysfunction. The correlation of preoperative HF and coexisting lesions with postoperative LV dysfunction was not statistically significant. Two patients underwent redo surgery for residual RSOV and AR. Two patients had arrhythmias. One patient had cerebrovascular accident. No mortality was seen in the study. Conclusion: Preoperative HF and the presence of VSD and/or AR have no statistical significant correlation with postoperative LV dysfunction. As the outcome of RSOV repair is good, all patients need to undergo early repair to avoid complications.

Ruptured sinus of Valsalva aneurysms – our surgical experience of 7 years

“…VSD is most commonly found in these patients and we encountered a very high percentage (52%) of VSDs. Many previous studies have quoted a higher percentage of VSD as compared to AR in these patients [ 11 – 18 ]. Considerable AR was present in only 3 of our patients pre-operatively.…”

Ruptured Sinus of Valsalva Aneurysm: Three Case Reports and Literature Review

“…The clinical presentation of SOVAR is characterized by previously healthy individuals between the ages of 20 and 40 who develop a loud, machinery-like, continuous murmur during systole and diastole, with the best heart at the base of the heart [ 7 ]. There are two clinical patterns of symptoms of SOVAR: the acute rupture of a large Sinus of Valsalva aneurysm and the gradual progression of a small perforation.…”

Rupture of sinus of Valsalva aneurysm: case report and review of contemporary literature

“…The mean ages documented range from 30 to 45. 4,6,9,10 The classic physiology of ruptured SoVA is a left to right shunt as the majority arise in the right or non-coronary aortic sinuses and open into the right heart (right atrium – 39%; right ventricle – 34%). 7 This may have profound haemodynamic effects and give rise to congestive cardiac failure.…”