Subannular aneurysms associated with acute, massive aortic insufficiency

Abstract

Fourteen cases of subannular aortic aneurysms are reviewed. The anatomic and bacteriologic characteristics of these lesions suggest that the infection developed in a previously abnormal heart, with subannular aneurysms developing in malformations at the base of the aorta. The usual septal location of these aneurysms suggests that the developmental defect represents a “forme fruste” of interventricular septal defects. Our experience indicates the treatment of choice is patching of these lesions as if they were interventricular septal defects, rather than approximation of the lips of the aneurysm by sutures. The role of the bacteria involved in the bacterial endocarditis as a factor in the anatomic lesions is considered.