Ruptured aneurysms of the sinus Valsalvae

Ruptured aneurysms of the sinus Valsalvae are relatively rare. Six patients have undergone operative treatment in our hospital in a 13-year period. Five of these, all men between the ages of 33 and 54 had a ruptured congenital aneurysm. Acquired aneurysms may occur and rupture at any age. One patient in our series had a mycotic aneurysm. Endocarditis was quite frequently encountered and seemed to play a role at the onset of rupture. Surgical technique consisted of direct closure in 4 patients and closure with a Dacron patch in 2 patients. Repair was successful in 5 patients. The patient with the mycotic aneurysm died after repeated surgery because of septic complications. Mean follow-up now is 3 1/2 years. Ruptured aneurysms of the sinus Valsalvae should be treated operatively by a double approach and, in the presence of an acute progressive endocarditis, without delay.