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Ruptured sinus of valsalva aneurysms
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1983
Summary
Congenital ruptured aortic sinus of Valsalva aneurysms are rare but treatable. Surgical repair using a transaortic approach offers a good prognosis, even with coexistent cardiac defects.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Defects
- Aortic Aneurysms
Background:
- Ruptured aneurysms of the aortic sinuses of Valsalva are infrequent surgical cases.
- Congenital aneurysms typically originate in the right coronary or non-coronary sinus.
Purpose of the Study:
- To review surgical management and outcomes of ruptured aortic sinus of Valsalva aneurysms.
- To evaluate the effectiveness of the transaortic supravalvular approach.
Main Methods:
- Surgical repair of nine cases of ruptured congenital aortic sinus aneurysms between 1968-1971.
- Utilized patched mattress sutures and a transaortic supravalvular approach for closure.
- Corrected coexistent cardiac defects including ventricular septal defects (VSDs) and atrial septal defects (ASDs).
Main Results:
- All nine patients survived surgery with good prognosis.
- Significant left-to-right shunts and reduced aortic diastolic pressure were noted but patients were not critical.
- Two cases required reoperation for recurrent fistulation; two VSDs were detected intraoperatively.
- Congenital heart defects, including five VSDs, one ASD, and pulmonic stricture, were successfully repaired.
Conclusions:
- Surgical repair of ruptured aortic sinus of Valsalva aneurysms is effective with good outcomes.
- The transaortic supravalvular approach is the preferred method for safe aneurysmal base closure.
- VSDs associated with these aneurysms often require specific repair strategies.