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Surgical treatment of ruptured aneurysm of the sinus of Valsalva

Published online by Cambridge University Press:  19 August 2008


Guo Jia Qiang
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Zhu Xiao Dong
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Xie Gan Xing
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Cao Jian Xiang
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Xiao Ming Di
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Shen Zhong Lin
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Wu Qing Yu
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Li Zheng Guo
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Shi Cheng Wei
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing
Shang Hua
Affiliation:
From the Departments of Cardiac Surgery and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing

Summary

This study reviews the results of the surgical management of 154 cases of ruptured aneurysm of the sinus of Valsalva. Of the patients0 73% were male, with an average age of 28 years. An associated ventricular septal defect was found in 40% and 23% had aortic valvar regurgitation. The aneurysms originated from the right coronary sinus in 79% and from the non-coronary sinus in the remainders. The aneurysms ruptured into the right ventricle in 73%, into the right atrium in 27% and into the left ventricle in less than 1%. Operative mortality was 4.5%. Long-term follow-up was achieved in 80% of patients, with a mean duration of 5.7 years and a range from two months to 29 years. Preoperative aortic regurgitation and preoperative functional class (NYHA III or IV) were both predictive of a worse long-term outcome. The optimal surgical approach was closure of the distal end of the fistula by direct suture together with reinforcement of the aortic sinus with a Dacron patch.


Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

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References

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