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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 1999 December;40(6):787-91
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
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.