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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1999 December;40(6):787-91

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgical correction for sinus of Valsalva aneurysm

Zikri M. A., Stewart R. W., Cosgrove D. M.

From the Department of Thoracic and Cardiovascular Surgery The Cleveland Clinic Foundation, Cleveland, OH, USA


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Back­ground. To eval­uate the effi­cacy of sur­gical cor­rec­tion of ­sinuses of Val­salva aneu­rysms, 24 ­patients oper­ated on ­from 1974-1994 ­were ­reviewed. ­Mean age was 42.2±16.7 ­years; 17 ­were ­males.
­Methods. ­Right cor­o­nary ­sinus was ­affected in 13 ­patients and non­cor­o­nary ­sinus in 8. Intra­car­diac fis­tula was ­detected in 16 ­patients: ­into the ­right ­atrium in 8; ­right ven­tricle in 5; ­left ven­tricle in 2; and ­left ­atrium in 1. ­Repair was per­formed via an ­aortic ­approach in 11 ­patients and a com­bined ­aortic and intra­car­diac ­approach in 13 ­patients. ­Suture clo­sure of the fis­tula was via the ­aortic ­side in 10 ­cases and the intra­car­diac ­side in 6. Ten ­patients had ­patch clo­sure via the ­aortic ­side.
­Results. ­Follow-up was 92% com­plete at a ­mean of 8.4 ­years ­with 3 ­late car­diac and 1 non­car­diac ­deaths. ­Eighty-­eight per­cent of ­patients are in New ­York ­Heart Asso­ci­a­tion func­tional ­class I or II; ­none under­went reop­er­a­tion.
Con­clu­sions. ­Sinuses of Val­salva aneu­rysm ­repair ­have low oper­a­tive mor­tality and mor­bidity ­risks ­with excel­lent ­early and ­late ­results. Sur­gical ­approach is depen­dent ­upon the pre­senting ­pathology.

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