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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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