Ruptured Sinus of Valsalva Aneurysm: 10-Year Experience at Kaohsiung Veterans General Hospital

Abstract

We reviewed our 10 patients receiving repair of ruptured sinus of Valsalva aneurysm (RSVA) over 10 years. Methods: Between 1993 and 2002, a total of 10 cases of ruptured sinus of Valsalva aneurysm underwent surgical correction. These patients included six men and four women, with a mean age of 26.7 6.5 years (range 15-36 years). The incidence of RSVA in our cardiac surgical population was 0.27%. All 10 RSVA cases had their origin in the right coronary sinus, with aneurysms ruptured into the right ventricle in nine, and one into the right atrium. All 10 patients had a VSD (supracristal type in eight and perimembranous type in two), and four patients had moderate to severe aortic regurgitation diagnosed by preoperative echocardiogram and cineoangiogram. Associated findings included a history of endocarditis (1 case; 10%), and a secundum type atrial septal defect (1 case, 10%). Concomitant procedures were VSD repair in all patients, aortic valvuloplasty in four, aortic valve replacement in one, and ASD repair in one. Results: There was no early death or recurrence after the initial repair. No early or late complications occurred. One patient had SBE with severe AR received aortic valve replacement nine months after the initial operation. All patients who received aortic valve repair did not have more than grade I AR. All patients were in NYHA class I or II at their last follow-up. Conclusions: Surgical treatment of ruptured SVAs can be performed with an acceptably low operative risk ensuring good long-term event-free/symptom-free survival. Patch repair strategy is advocated from the experience of our RVSA cases.