European Journal of Cardio-Thoracic Surgery, Vol 6, 15-17, Copyright © 1992 by European Association for Cardio-thoracic Surgery
Ruptured aneurysms of the sinus of Valsalva
L Lukacs, I Bartek, A Haan, J Hankoczy and A Arvay
Hungarian Institute of Cardiology, Budapest, Hungary.
From 1969 to 1989, 15 patients with an aneurysm of the sinus of Valsalva
underwent operative correction. This represents 0.23% of 6515 cardiac
operations with cardiopulmonary bypass during that time. There were 8 males
and 7 females ranging in age from 15 to 54 years (mean 35.8 years).
Symptoms of congestive heart failure, fatigue and palpitation were common.
All patients underwent cardiac catheterization including aortography.
Associated lesions included aortic valve regurgitation in 6 patients and a
ventricular septal defect in 3 patients. The following connections
occurred: right coronary sinus to right ventricle (8 patients), right
coronary sinus to both right atrium and right ventricle (1 patient), and
noncoronary sinus to right atrium (6 patients). The aneurysm was repaired
via aortotomy or through the chamber into which it emptied. The aortic
valve was replaced in 2 patients. There were no early or late postoperative
deaths. Fourteen patients were in NYHA functional class I at late follow-up
(range 0.5 to 20.5 years, mean 8.7 years). There have been no recurrences.
Our experience supports the concept that early surgical intervention in
patients with ruptured aneurysms of the sinus of Valsalva is justified.
