Totally Endoscopic Patch Repair for Ruptured Sinus of Valsalva Aneurysm Associated With Ventricular Septal Defect

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Minimally Invasive Cardiac Surgery

Background:

• Ruptured sinus of Valsalva aneurysm (RSVA) with ventricular septal defect (VSD) is a rare congenital heart condition.
• These defects often lead to heart failure due to left-to-right shunting, necessitating surgical intervention.

Purpose of the Study:

• To report the successful surgical management of two cases of RSVA with concomitant infundibular VSD.
• To evaluate the feasibility and outcomes of a totally endoscopic approach for this complex condition.

Main Methods:

• Two young adult patients with RSVA and infundibular VSD underwent surgical repair.
• A totally endoscopic technique was employed, utilizing an aortotomy for access.
• Patch repair of the RSVA and VSD closure were performed under endoscopic visualization.

Main Results:

• Both patients were successfully treated with no residual shunt detected postoperatively.
• Patients were discharged uneventfully, with stable mid-term follow-up.
• Mild aortic regurgitation was noted but remained stable.

Conclusions:

• Totally endoscopic repair of RSVA associated with VSD is a feasible and effective surgical option.
• This minimally invasive approach can be successfully achieved through an aortotomy alone.
• Endoscopic surgery offers a viable alternative for treating complex congenital heart defects like RSVA with VSD.