Korean J Med.
2002 Nov;63(5):532-538.
Ruptured sinus of valsalva aneurysms : Clinical features and surgical results
- Affiliations
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- 1Division of Cardiology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. pjs@medical.yeungnam.ac.kr
- 2Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 3Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- 4Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
- 5Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Paik Hospital, Busan, Korea.
Abstract
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BACKGROUND: Aneurysms of sinus Valsalva are rare anomalies thought to be primarily congenital in origin. To evaluate the clinical features and surgical results associated with ruptured aneurysm of sinus of Valsalva, we reviewed the clinical characteristics and follow up results of the patients.
METHODS
From January, 1991, through June 2001, 33 patients with ruptured aneurysm of sinus of Valsalva underwent surgical correction from the above five university hospitals. The patients included 24 men and 9 women, with a mean age of 32+/-13 years. We reviewed symptoms, physical examination findings, ECG findings, the coexistent cardiac anomalies, echocardiographic findings, surgical results in 33 patients.
RESULTS
Patterns of fistula tract were right coronary sinus-right ventricle in 24 patients (73%), noncoronary sinus- right atrium in 3 patients (9%), noncoronary sinus - right ventricle in 3 patients (9%), right coronary sinus - right atrium in 2 patients (6%) and right coronary sinus - right ventricle and right atrium in 1 patient (3%). Combined cardiac anomalies were VSD (20 cases; 61%), ASD (1 case; 3%) and PDA (1 case; 3%). But, only 12 cases of VSD (60%) were diagnosed with preoperative transthoracic echocardiography. The aneurysmal sacs were excised in all patients and the defects were closed with a patch in 21 patients (64%) and without patch in 12 patients (36%). No recurrence was observed during follow-up periods (68+/-38 months) for all survivors and there was no late complications or symptoms.
CONCLUSION
In sinus of Valsalva aneurysm patients, combined cardiac anomalies, especially VSD, are common. Careful preoperative echocardiography should be performed to detect combined anomalies. And, surgical results are excellent without recurrence.
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