Surgical Correction of Ruptured Aneurysm of the Sinus of Valsalva

1997 ◽  
Vol 5 (3) ◽  
pp. 144-148
Author(s):  
Cao Song ◽  
Qiu Zhao Kun ◽  
Gu Wei Li ◽  
Chang Yuan ◽  
Shi Wei ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Surgical Management ◽  
Coronary Sinus ◽  
Surgical Correction ◽  
Ruptured Aneurysm ◽  
Aortic Valve Insufficiency ◽  
Sinus Of Valsalva ◽  
Ruptured Aneurysms ◽  
Valve Insufficiency ◽  
The Right

Between January 1983 and December 1996, 108 patients with ruptured aneurysms of the sinus of Valsalva underwent surgical correction in Shanghai Chest Hospital. The aneurysms ruptured into the right ventricle in 91 patients, into the right atrium in 16, and into the left atrium in 1. The aneurysm originated from the right coronary sinus in 82 patients, from the noncoronary sinus in 25, and from the left coronary sinus in 1. Associated intracardiac defects included ventricular septal defect in 52, aortic valve insufficiency in 67, and patent ductus arteriosus in 2. A ruptured aneurysm of the sinus of Valsalva without aortic valve insufficiency was approached via the cardiac chamber into which it ruptured. When the aneurysm was associated with moderate or severe aortic valve insufficiency we preferred the transaortic approach for repair. The aneurysm was excised at its base and repaired with a Dacron patch regardless of the size of the base of the aneurysm. Active surgical management of aortic valve insufficiency was performed at the initial operation using valve suspension in 25 patients with moderate aortic valve insufficiency and replacement with a mechanical valve prosthesis in 6 cases of severe aortic insufficiency. The early mortality was 2.78%. The median follow-up period was 3.9 years. Of the 72 patients who were followed up, 67 are in New. York Heart Association functional class I or II and 5 are in class III or IV due to severe aortic valve insufficiency. Considering the pathoanatomic features and hemodynamic changes associated with ruptured aneurysms of the sinus of Valsalva in Oriental patients, we advocate repairing the defect with a patch in all cases and stress the importance of active surgical management for aortic valve insufficiency at the initial surgical correction.

Surgical treatment of ruptured aneurysm of the sinus of Valsalva

1994 ◽  
Vol 4 (4) ◽  
pp. 347-352 ◽  
Author(s):  
Guo Jia Qiang ◽  
Zhu Xiao Dong ◽  
Xie Gan Xing ◽  
Cao Jian Xiang ◽  
Xiao Ming Di ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Functional Class ◽  
Ruptured Aneurysm ◽  
Sinus Of Valsalva ◽  
Aortic Sinus ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
The Right

SummaryThis study reviews the results of the surgical management of 154 cases of ruptured aneurysm of the sinus of Valsalva. Of the patients0 73% were male, with an average age of 28 years. An associated ventricular septal defect was found in 40% and 23% had aortic valvar regurgitation. The aneurysms originated from the right coronary sinus in 79% and from the non-coronary sinus in the remainders. The aneurysms ruptured into the right ventricle in 73%, into the right atrium in 27% and into the left ventricle in less than 1%. Operative mortality was 4.5%. Long-term follow-up was achieved in 80% of patients, with a mean duration of 5.7 years and a range from two months to 29 years. Preoperative aortic regurgitation and preoperative functional class (NYHA III or IV) were both predictive of a worse long-term outcome. The optimal surgical approach was closure of the distal end of the fistula by direct suture together with reinforcement of the aortic sinus with a Dacron patch.

scholarly journals Alternative Surgical Approach to Repairing a Giant Sinus of Valsalva Aneurysm

2016 ◽  
Vol 43 (1) ◽  
pp. 43-44 ◽  
Author(s):  
Vincenzo Giambruno ◽  
Cristina Cucchietti ◽  
Calogera Pisano ◽  
Jonathan Hyde
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Sinus ◽  
Surgical Approach ◽  
Bypass Graft ◽  
Giant Aneurysm ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
The Right

We report our method of surgically repairing an unruptured giant aneurysm of the right coronary sinus of Valsalva, a lesion that caused moderate aortic regurgitation but no symptoms in a 61-year-old woman. We excised the aneurysm, reconstructed the right sinus of Valsalva with use of a patch, performed mechanical aortic valve replacement directly through the excised aneurysm's cavity, and constructed a single bypass graft to the right coronary artery. The patient was discharged from the hospital after 5 days. Twelve months postoperatively, her clinical and echocardiographic results were normal, and she was doing well. To our knowledge, our surgical approach to this repair has not been described previously.

scholarly journals Outcomes of Ruptured Sinus of Valsalva Aneurysm -A 20-year experience

2021 ◽  
Author(s):  
Harshavardhan Niraghatam ◽  
Dipika Naraimathi ◽  
Utkarsh Sanghavi ◽  
Aditya N. Doddamane ◽  
Channabasavaraj Hiremath ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Elective Surgery ◽  
Aortic Insufficiency ◽  
Sinus Of Valsalva ◽  
Ruptured Aneurysms ◽  
Aortic Media ◽  
Aortic Incompetence ◽  
The Right

Background: Ruptured aneurysms of sinus of Valsalva are defects of the aortic media, which are uncommon yet present concomitantly with either ventricular septal defect, aortic insufficiency or both. Here, we analyse retrospectively outcomes of patients operated on in the last two decades. Patients and Methods: 151 cases of ruptured aneurysms of sinuses of Valsalva were treated here between January 2000 and December 2020. The majority (96%) arose from the right coronary sinus. The right ventricular outflow was the most common site of rupture (56.2%). Ventricular septal defect was associated in 24 patients (16%) all of whom had ruptured right sinus, of which 8 (33%) were of subpulmonic subtype. Aortic incompetence was found in 45 patients (43.3%). Elective surgery was offered to 78 patients (51.6%), while the rest had defects closed by interventional devices. Surgical conversion for device embolization occurred in 12 patients (7.94 %). The defect was closed through the aortic root in 13 patients (14.4% of 90) and employing the bicameral technique (root and ruptured chamber) in the remaining 87 patients. 18 patients (20%) underwent aortic valve repair while 5 (5.5%) underwent aortic valve replacement. Results: We had no hospital deaths, however 4 operated patients (2.6%) had comorbidities. Follow‐up ranged from 1 to 20 years (mean 13 ± 5). There were 3 deaths in this period, and among the majority, quality of life was uneventful. Conclusion: Surgical correction for ruptured aneurysms of Valsalva provides prudent results and must be the preferred modality of treatment in acute and chronic presentation.

scholarly journals Sinus of Valsalva aneurysm and bicuspid aortic valve: detection and mechanism by cardiac magnetic resonance imaging

2011 ◽  
Vol 1 (3) ◽  
pp. 72
Author(s):  
Jen Li Looi ◽  
Andrew J. Kerr
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Valve ◽  
Cardiac Magnetic Resonance Imaging ◽  
Coronary Sinus ◽  
Sinus Of Valsalva ◽  
Resonance Imaging ◽  
Sinus Of Valsalva Aneurysm ◽  
The Right

Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA) with severe dilatation of the right coronary sinus in association with a congenital bicuspid aortic valve (BAV) and subaortic membrane. The SVA had not been apparent on echocardiography as the dilatation was outside standard echo image planes. On both CMR and echo, blood flow was eccentrically directed into the right coronary sinus by the domed posterior leaflet of the BAV. The impact of the aortic jet on the wall of the right coronary sinus is probably important in the aetiology of the sinus dilatation. CMR proved valuable in demonstrating the SVA and understanding its aetiology.

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