Surgical Repair and Long Term Results in Sinus of Valsalva Aneurysm: Twelve Year Experience / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Sinus of Valsalva aneurysm is a rare cardiac anomaly and a long-term survival after surgical treatment has not been well established. This study was designed to evaluate the long-term surgical results after the repair of sinus Valsalva aneurysm. MATERIAL AND METHOD: From April 1991 to November 2003, 35 patients (23 male, 12 female, mean age 35.2 years, range 11~64) underwent operation for sinus of Valsalva aneurysm. Twenty six patients (74.3%) were in the New York Heart Association (NYHA) class III~IV before surgery. In preoperative echocardiogram, mean EF was 63.32+/-11.43% and nine patients (25.7%) were in AR grade III~IV. Direct closure, patch closure of ruptured sinus Valsalva were performed in fourteen patients (46.7%), sixteen patients (53.3%) respectively. Aortic valve replacement, valvuloplasty were performed in five patients (14.3%), three patients (8.6%) respectively. Three patients (8.6%) underwent the Bentall procedure. Concomitant procedures were performed in 15 patients (42.9%), which were closure of VSD and ASD. Mean CPB time and ACC time were 116.79+/-38.79 and 81.2+/-28.97 minutes. RESULT: There was no operative mortality. One patient (2.9%) developed complete heart block that required a permanent pacemaker implantation. Three patients (8.6%) required reoperation due to a recurred rupture of the sinus Valsalva aneurysm and developed aortic insufficiency. Mean follow-up time was 58.55+/-38.38 months. There was one late death. Actuarial 5 year freedom rate from reoperation was 87.1+/-7%. CONCLUSION: Surgical treatment for sinus of Valsalva aneurysm is safe and has satisfactory long-term results.