Clinical Characteristics in Patients with Ruptured Aneurysm of Sinus of Valsalva

ABSTRACT

BACKGROUND: Ruptured aneurysms of sinus of Valsalva are rare cardiac anomaly. Here, we analyze retrospectively patients operated on at our hospital during the last 10 years. METHODS: Seventeen cases of ruptured congenital aneurysm of sinus of Valsalva (femalemale=107, mean age 33.2+/-15.2 year) were operated during the period of January 1989 through August 1998. A ruptured aneurysm of the sinus of Valsalva was diagnosed by transthoracic 2D echocardiography and multiplane esophageal echocardiography. The diagnoses were confirmed at operation. The majority (94.1%) arose from the right coronary sinus. The right ventricle was the most common chamber of rupture (76.5%). Ventricular septal defect was associated in 13 patients (76.5%), of which 8 (61.5%) were subarterial. Ventricular septal defect was more common in aneurysms arising from the right coronary sinus (81.2%). Aortic regurgitation was found in 5 patients (29.4%). One patient underwent aortic valve repair and one an arotic valve replacement. RESULTS: There was no early operative death and no recurrence after the initial repair. Postoperative morbidities were few. There was one late sudden cardiac death 3 months post-surgery. In the majority, the long-term follow-up was uneventful. CONCLUSION: Surgery for ruptured aneurysm of sinus of Valsalva yields gratifying results, and it should be undertaken as soon as the condition is diagnosed. With recent developments, echocardiography may prove a substitute for cardiac catheterization and angiocardiography in future, and surgery could be undertaken with the help of echocardiography alone.