Ruptured sinus of Valsalva aneurysm: 10-year Indian surgical experience

Abstract

Sinus of Valsalva aneurysm is a rare anomaly with a higher incidence in Eastern than Western populations. Recent improvements in diagnostic techniques have resulted in more patients undergoing surgical repair. Uncorrected, the intracardiac shunts and frequently associated cardiac lesions cause a preventable deterioration in heart function. We retrospectively analyzed the data of 33 patients who underwent repair of ruptured sinus of Valsalva aneurysm from May 2000 to January 2010. The aneurysms originated from the right coronary sinus in 24 patients and from the noncoronary sinus in 9, and ruptured into the right ventricle in 21, right atrium in 10, and left ventricle in 2. Operative procedures included simple plication (1), patch repair (32), and aortic valve replacement (10). There were 3 early deaths. The 30 survivors were followed up for 5.4 ± 2.6 years; all had an improvement in functional class, with superior results in those with no aortic regurgitation. Surgical treatment of ruptured sinus of Valsalva aneurysm has an acceptably low operative risk and good long-term symptom-freedom survival. An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease.

Angiographic features of ruptured sinus of Valsalva aneurysm: New classification

“…The proportion of patients in NYHA class III/IV was reduced from 73.3% at baseline to 10% at the time of last follow-up. A similar closure rate in RSVA with surgical closure has also been reported to be between 90.9% and 95.0% [20,21]. Excellent results of percutaneous closure indicate that it is a promising alternative to surgery in appropriately selected patients.…”

Surgical Management of the Aortic Root

“…Other recent retrospective trials have been published. [133,134] Again the vast majority of patients (>90%) were able to attain fixation with either direct closure or patch techniques. Approach for fixation was usually obtained through the chamber that rupture of the aneurysm occurred.…”

Our 16-year experience in surgical treatment of aneurysms of sinus of Valsalva

“…Giderek gelişmekte olan tanı yöntemleri ile birlikte cerrahi geçiren SVA'lı hastaların sayısı artmaktadır. [2] Ancak yine de nadir olarak görülmekte olup, nadir görülen tüm patolojilerde olduğu gibi burada da bir cerrahi yaklaşımın diğerine üstünlüğünü kanıtlayabilmiş klinik çalışma bulunmakatadır. Bu çalışmada SVA'nın cerrahi onarımındaki 16 yıllık deneyimimizi gözden geçirerek, hastaların ameliyat sırası ile ameliyat sonrası erken ve geç dönem sonuçlarını analiz edebilmeyi amaçladık.…”