Ruptured sinus of Valsalva aneurysm: A Beijing experience

Background. Ruptured sinus of Valsalva aneurysm, (RSVA) is relatively common in oriental patients. We retrospectively analyzed 67 patients receiving repair of RSVA in a Beijing hospital over 5 years. Methods. Between October 1, 1996 and September 30, 2001, at Fu Wai Hospital, 67 patients with RSVA underwent surgical repair, 0.78% of all congenital open-heart operations. Forty-four were male and 23 female. Age ranged from 2 to 57 years old (mean 32 +/- 10 years). The RSVA originated in the right (n = 52) or noncoronary (n = 15) sinus. Rupture into the right ventricle was most common (n = 39) with 26 going to the right atrium and two to the left ventricle. Associated cardiovascular lesions were ventricular septal defect (n = 32) and aortic valve incompetence (n = 12). Repair was achieved through an incision in the cardiac chamber of the fistula exit in 61 patients. Aortotomy was used in three patients and both routes were used in three patients. The sinus of Valsalva was repaired with either a patch (n = 63) or direct sutures (n = 4). The aortic valve was replaced in 12 patients. Results. All but 1 patient (n = 66) survived the 30-day operative interval. One patient died of an anticoagulation complication 2 months after the operation. Late complications included residual shunt (n = 2), peri-prosthetic leakage (n = 1), and aortic incompetence (n = 1). Conclusions. In this relatively high-risk population, repair of RSVA can be achieved with satisfactory early results. (C) 2002 by The Society of Thoracic Surgeons.