Transcatheter closure of ruptured sinus of Valsalva aneurysm using the Amplatzer duct occluder: immediate results and mid-term follow-up

Kerkar, Prafulla; Lanjewar, Charan; Mishra, Nidheesh; Nyayadhish, Prasanna; Mammen, Isaac

doi:10.1093/eurheartj/ehq323

Cited by 85 publications

(106 citation statements)

References 14 publications

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“…Even interventional closure of RSOV in the cardiac catheterization laboratory has been reported. 12 However, the optimal surgical approach is yet to be defined. Controversies exist about RSOV repairs among various centers are the surgical approach (chamber involved, transaortic or both) and the closure technique (primary/ patch closure).…”

Section: Discussionmentioning

confidence: 99%

Management of the ruptured sinus of valsalva aneurysmsa

et al. 2017

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Background: RSOV is associated with a dramatic onset of symptoms to a state of biventricular failure due to sudden volume overload. Controversies exist about RSOV repairs among various centers are the surgical approach (chamber involved, transaortic or both) and the closure technique (primary/ patch closure). There have been no clinical trials to show that one technique is superior to other. In the present study, we reviewed our 16 years’ experience with repair of RSOV through exclusive transaortic approach.Methods: 40 patients underwent RSOV repair through transaortic approach from January 2000 to December 2016. The mean age was 30.2 years. The origin of RSOV was right coronary sinus in 75% of cases and non-coronary sinus in 22.5% of cases. There was one giant calcified unruptured aneurysm arising from right coronary sinus. Right ventricle was most common chamber of rupture comprising 96.67% cases. All patients underwent transaortic repair of RSOV using dacron patch. VSD repair was done in 25% cases. Aortic valve replacement was done in 62.5% cases for moderate to severe AR.Results: There were 7.5% in hospital deaths with no late deaths. Inotropic and ventilatory support required for 3±1.6 days and 1.8±1.2 days respectively. The mean ICU stay and hospital stay was 3.5±1.6 days and 7.5±2.5 days respectively. None of the patient required permanent pacemaker implantation. The 37 survivors were followed up for 6.4±3.6 years; all had an improvement in functional NYHA class with superior results in those with no aortic regurgitation. 7.5% patients developed mild AR during follow up which medical management was done.Conclusions: Surgical treatment of ruptured sinus of Valsalva aneurysm using the transaortic patch technique has an acceptably low operative risk, lesser distortion of aortic valve and good long-term symptom-freedom survival. An early aggressive approach is recommended to prevent worsening of symptoms and more extensive disease.

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Section: Discussionmentioning

confidence: 99%

Management of the ruptured sinus of valsalva aneurysmsa

et al. 2017

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“…Unlike Arora et al [7] we did not utilize balloon sizing of the defect since we were able to size the defect well on TEE. We attempted to close the ruptured SOVA at the aortic end similar to a 'surgeon's repair' since closure at the rupture site (exit point) would leave behind an aneurismal sac exposed to arterial pressure with a potential to rupture at another site in the long term [8].…”

Section: Discussionmentioning

confidence: 99%

Successful transcatheter closure of very large ruptured sinus of Valsalva aneurysm

Sinha¹,

Khanna²,

Mishra³

et al. 2017

Acta Angiologica

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“…Defects larger than 10 mm were closed by Guan et al using 14 to 18 mm PDA device. 9,10 We chose CDO (►Fig. 3) because of our familiarity with this device and price concerns.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm: Immediate Result and Long-Term Follow-Up

Sinha¹,

Vipperla²,

Mahapatro³

2015

Int J Angiol

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There is scarcity of data on closure and long-term follow-up of percutaneous treatment of ruptured sinus of Valsalva aneurysm (RSOVA). In this article, we present our experience in percutaneous closure of this defect. Between December 2009 and July 2014, 11 cases of RSOVA were referred to our hospital. Eight of the 11 cases (72.7%) were considered for percutaneous closure. Seven of the eight (87.5%) patients underwent successful percutaneous closure. There were four females and three males in the age group of 16 to 48 years (mean 24.7???6.1 years). Associated defects were bicuspid aortic valve in one patient, mild preexisting aortic regurgitation in two patients, and healed infective endocarditis in one patient. Echocardiography revealed RSOVA from right coronary sinus (RCS) to right atrium (RA) in one patient (14.3%), RCS to right ventricular outflow in three patients (42.8%), and noncoronary sinus ruptured into RA in three patients (42.8%). All patients were symptomatic in New York Heart Association (NYHA) class II to IV. The defect size ranged from 7 to 10?mm (mean 8.4???1.3 mm). The defects were closed from the venous side with device selection 2 to 4?mm higher than the defect size under fluoroscopy and transesophageal echocardiography guidance. Technical success was 87.5%. The mean device size was 12.0???1.6 mm/10.0???1.6 mm. Six out of seven patients (85.7%) had complete disappearance of shunt before discharge. During 1 to 55 months follow-up, all patients were in NYHA class I. There was no residual shunt, progression of AR or new AR, infective endocarditis or device embolization. Percutaneous closure of RSOVA appears to be a safe alternative to surgical therapy, with high technical success and excellent long-term outcome.

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Transcatheter closure of ruptured sinus of Valsalva aneurysm using the Amplatzer duct occluder: immediate results and mid-term follow-up

Abstract: In appropriately selected patients with ruptured SOVA, TCC is an attractive alternative to surgery with encouraging short- and mid-term outcomes.

Cited by 85 publications

References 14 publications

Management of the ruptured sinus of valsalva aneurysmsa

Management of the ruptured sinus of valsalva aneurysmsa

Successful transcatheter closure of very large ruptured sinus of Valsalva aneurysm

Percutaneous Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm: Immediate Result and Long-Term Follow-Up

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