Percutaneous closure of ruptured sinus of Valsalva aneurysm: results from a multicentre experience

Aims: To evaluate the safety and efficacy of percutaneous closure (PC) using modified double-disc ventricular septal defect (VSD) occluders in patients with ruptured sinus of Valsalva aneurysm (RSVA). Methods and results: Between 2005 and 2012, 25 patients were enrolled in our study for attempted PC. There were five patients (20%) with RSVA combined with VSD and two (8%) with aortic regurgitation (AR). The median age was 45 years (24-74 years). The Q(p)/Q(s) was 2.410.6 (1.6-4.0). The median diameter of lesions was 6 mm (4-8 mm) while the median size of occluders was 8 mm (6-12 mm). Twenty-three patients (92%) underwent PC successfully. Occluders were retrieved in two patients within one week. Trivial residual shunts developed in three and mild occluder-related AR occurred in five at discharge. During a median follow-up of 19 months (6-96 months) all trivial residual shunts vanished and mild occluder-related AR disappeared in four out of five patients. The proportion of patients in NYHA Class III/IV was reduced from 72% at baseline to 12% at the time of last follow-up (p<0.001). Conclusions: In selected patients with RSVA, PC using modified double-disc occluders may become a valuable alternative to surgery with encouraging immediate outcomes and midterm results.