ABSTRACT
Localized aneurysms of the sinus of Valsalva are uncommon. Repair is tailored to the defective anatomy of the sinus, the aortic valve, and the coronary artery. Herein, we report the successful surgical treatment of 2 patients who had unruptured pseudoaneurysms of the sinus of Valsalva. An evident fissure in the intima of the sinus of Valsalva was seen in both patients. Patient 1 was a 57-year-old man with annuloaortic ectasia who was diagnosed with pseudoaneurysm of the right sinus of Valsalva. A thrombus that had formed in the pseudoaneurysm subsequently migrated into the right coronary artery. Aortic root remodeling was performed. Patient 2 was a 23-year-old man with a history of blunt chest trauma. He developed a pseudoaneurysm in the right sinus of Valsalva and tears on the aortic cusps. He underwent aortic valve replacement and repair of the Valsalva wall.
Subject(s)
Aneurysm, False/diagnosis , Aneurysm, False/surgery , Aortic Aneurysm/diagnosis , Aortic Aneurysm/surgery , Sinus of Valsalva , Adult , Aneurysm, False/etiology , Aorta, Thoracic , Aortic Aneurysm/etiology , Humans , Male , Middle Aged , Thoracic Injuries/complications , Thrombosis/complicationsABSTRACT
In valve-sparing operations for aortic root aneurysms, the dilated aortic root is replaced by a vascular graft. However, cusp disorders remain in some cases. We observed closed cusps endoscopically, and an improvement in the cusp coaptation was seen following plication. One of our cases of aortic valve plication is reported here. A rigid thoracoscope and cannula for cardioplegia delivery were inserted from the distal end of the aortic graft, and the graft was inflated with cardioplegic solution, providing an endoscopic view of the closed aortic cusps. We believe that endoscopic observation of closing cusps in this way may help surgeons to learn and master the techniques used in cusp repair more rapidly.
