Surgical Treatment for Unruptured Aneurysm of the Sinus of Valsalva_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LUOXin-jin ¹ , WANGShu-xia ² , QIUJun-tao ¹ , WANGWei ¹

1. Department of Cardiovascular Surgery, Cardiovascular Institute and Fu wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China;
2. Function Test Department of Heart Center, General hospital of Ningxia Medical University, Yinchuan 750000, P. R. China;

Corresponding author：

LUOXin-jin, Email: luoxinjin@yahoo.com

Keywords：

Congenital heart disease; Unruptured aneurysm of the sinus of Valsalva; Surgical treatment

DOI：

10.7507/1007-4848.20150060

Video：

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Objective To summarize surgical treatment experience on unruptured aneurysm of the sinus of Valsalva (SVA). Methods Clinical data of 33 patients with unruptured SVA underwent surgical repair at Fu wai Hospital between February 2007 and January 2012 were retrospectively analyzed. There were 27 males and 6 females with their mean age of 28.5±13.5 years (ranged from 4.5 to 58.0 years). The unruptured SVA originated in the right coronary sinus in 29 cases (87.8%), in non-coronary in 2 cases (6.1%) and in left coronary sinus in 2 cases (6.1%). There were 29 cases with ventricular septal defect and 20 cases with aortic valve insufficiency (AI). Results Only 52.8% of unruptured SVA were correctly diagnosed by echocardiography preoperatively. All unruptured SVA received active surgical management, with no early death after operation. Thirty patients (90.9%) were followed up for 22 to 81 months (mean 42.9±18.8 months) and in NYHA classⅠorⅡ. None SVA recurrence occurred. Postoperative AI could be improved better by using the repair route only through the chamber of right ventricle for patients with unruptured SVA originated in right coronary sinus. Conclusion For unruptured SVA patients who associated with other kinds of cardiovascular lesions, active surgical repair for unruptured SVA can achieve satisfactory results.

Citation： LUOXin-jin, WANGShu-xia, QIUJun-tao, WANGWei. Surgical Treatment for Unruptured Aneurysm of the Sinus of Valsalva. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 211-214. doi: 10.7507/1007-4848.20150060 Copy

1.	Takach TJ, Reul GJ, Duncan JM, et al.Sinus of Valsalva aneurysm or fistula:management and outcome.Ann Thorac Surg, 1999, 68(5):1573-1577.
2.	Wang ZJ, Zhou CW, Li DC, et al.Surgical repair of sinus of Valsalva aneurysm in Asian patients.Ann Thorac Surg, 2007, 84(1):156-160.
3.	Dong C, Wu QY, Tang Y.Ruptured sinus of Valsalva aneurysm:a Beijing experience.Ann Thorac Surg, 2002, 74(5):1621-1624.
4.	Chu SH, Hung CR, How SS, et al.Ruptured aneurysms of the sinus of Valsalva in oriental patients.J Thorac Cardiovasc Surg, 1990, 99(2):288-298.
5.	Li F, Chen S, Wang J, et al.Treatment and outcome of sinus of Valsalva aneurysm.Heart Lung Circ, 2002, 11(2):107-111.
6.	Guo HW, Sun XG, Xu JP, et al.A new and simple classification for the non-coronary sinus of Valsalva aneurysm.Eur J Cardiothorac Surg, 2011, 40(5):1047-1051.
7.	Edwards JE, Burchell HB.The pathological anatomy of deficiencies between the aortic root and the heart, including aortic sinus aneurysms.Thorax, 1957, 12(2):125-139.
8.	Kritharis EP, Iliopoulos DC, Papadodima SA, et al.Effects of aneurysm on the mechanical properties and histologic structure of aortic sinuses.Ann Thorac Surg, 2014, 98(1):72-79.
9.	Ellis A, Kalogeropoulos A, Chung A, et al.Cyanosis due to unruptured aneurysm of the sinus of Valsalva.Tex Heart Inst J, 2011, 38(4):448-449.
10.	Rosu C, Basile F, Prieto I, et al.Unusual presentation of an isolated unruptured aneurysm of the right sinus of Valsalva causing compression of the right ventricular outflow tract.Eur J Cardio-thorac Surg, 2010, 38(4):504.
11.	Shah AJ, Pocock JM, Belham M, et al.Aneurysm of the sinus of Valsalva.Cardiol J, 2010, 17(3):312-313.
12.	Saritas A, Unal EU, Caliskan A, et al.Unruptured sinus of Valsalva aneurysm displacing the right atrium.Eur J Cardiothorac Surg, 2012, 42(4):745.
13.	Le DD, Orrego CM, Maragiannis D, et al.An unusual case of right-sided heart failure caused by giant sinus of Valsalva aneurysmobstructing right ventricular outflow tract.Eur Heart J, 2014 Jun 16.[Epub ahead of print].
14.	Dayan J, Sett S, Krishnan U.Silent rupture of sinus of Valsalva aneurysm:a refutation of the Okham's razor principle.Cardiol Young, 2011, 21(6):713-715.
15.	Ott DA.Aneurysm of the sinus of valsalva.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:165-176.
16.	Feldman DN, Roman MJ.Aneurysm of the sinus of Valsalva.Cardiology, 2006, 106(2):73-81.
17.	罗新锦, 李轩, 彭博, 等.主动脉窦瘤破裂的改良分型.中国胸心血管外科临床杂志, 2013, 20(3):264-268.
18.	Tessitore G, Alamanni F, Ali SG, et al.Direct closure of an asymptomatic right coronary sinus of Valsalva aneurysm.Asian Cardiovasc Thorac Ann, 2013, 22(5):601-603.
19.	Minagawa T, Watanabe S, Kanda K, et al.Surgical treatment for an asymptomatic and unruptured sinus of Valsalva aneurysm:report of a case.Surg Today, 2013, 43(10):1199-1201.
20.	Nascimbene A, Joggerst S, Reddy KJ, et al.Aortic valve regurgitation that resolved after a ruptured coronary sinus aneurysm was patched.Tex Heart Inst J, 2013, 40(4):489-492.

1. Takach TJ, Reul GJ, Duncan JM, et al.Sinus of Valsalva aneurysm or fistula:management and outcome.Ann Thorac Surg, 1999, 68(5):1573-1577.
2. Wang ZJ, Zhou CW, Li DC, et al.Surgical repair of sinus of Valsalva aneurysm in Asian patients.Ann Thorac Surg, 2007, 84(1):156-160.
3. Dong C, Wu QY, Tang Y.Ruptured sinus of Valsalva aneurysm:a Beijing experience.Ann Thorac Surg, 2002, 74(5):1621-1624.
4. Chu SH, Hung CR, How SS, et al.Ruptured aneurysms of the sinus of Valsalva in oriental patients.J Thorac Cardiovasc Surg, 1990, 99(2):288-298.
5. Li F, Chen S, Wang J, et al.Treatment and outcome of sinus of Valsalva aneurysm.Heart Lung Circ, 2002, 11(2):107-111.
6. Guo HW, Sun XG, Xu JP, et al.A new and simple classification for the non-coronary sinus of Valsalva aneurysm.Eur J Cardiothorac Surg, 2011, 40(5):1047-1051.
7. Edwards JE, Burchell HB.The pathological anatomy of deficiencies between the aortic root and the heart, including aortic sinus aneurysms.Thorax, 1957, 12(2):125-139.
8. Kritharis EP, Iliopoulos DC, Papadodima SA, et al.Effects of aneurysm on the mechanical properties and histologic structure of aortic sinuses.Ann Thorac Surg, 2014, 98(1):72-79.
9. Ellis A, Kalogeropoulos A, Chung A, et al.Cyanosis due to unruptured aneurysm of the sinus of Valsalva.Tex Heart Inst J, 2011, 38(4):448-449.
10. Rosu C, Basile F, Prieto I, et al.Unusual presentation of an isolated unruptured aneurysm of the right sinus of Valsalva causing compression of the right ventricular outflow tract.Eur J Cardio-thorac Surg, 2010, 38(4):504.
11. Shah AJ, Pocock JM, Belham M, et al.Aneurysm of the sinus of Valsalva.Cardiol J, 2010, 17(3):312-313.
12. Saritas A, Unal EU, Caliskan A, et al.Unruptured sinus of Valsalva aneurysm displacing the right atrium.Eur J Cardiothorac Surg, 2012, 42(4):745.
13. Le DD, Orrego CM, Maragiannis D, et al.An unusual case of right-sided heart failure caused by giant sinus of Valsalva aneurysmobstructing right ventricular outflow tract.Eur Heart J, 2014 Jun 16.[Epub ahead of print].
14. Dayan J, Sett S, Krishnan U.Silent rupture of sinus of Valsalva aneurysm:a refutation of the Okham's razor principle.Cardiol Young, 2011, 21(6):713-715.
15. Ott DA.Aneurysm of the sinus of valsalva.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:165-176.
16. Feldman DN, Roman MJ.Aneurysm of the sinus of Valsalva.Cardiology, 2006, 106(2):73-81.
17. 罗新锦, 李轩, 彭博, 等.主动脉窦瘤破裂的改良分型.中国胸心血管外科临床杂志, 2013, 20(3):264-268.
18. Tessitore G, Alamanni F, Ali SG, et al.Direct closure of an asymptomatic right coronary sinus of Valsalva aneurysm.Asian Cardiovasc Thorac Ann, 2013, 22(5):601-603.
19. Minagawa T, Watanabe S, Kanda K, et al.Surgical treatment for an asymptomatic and unruptured sinus of Valsalva aneurysm:report of a case.Surg Today, 2013, 43(10):1199-1201.
20. Nascimbene A, Joggerst S, Reddy KJ, et al.Aortic valve regurgitation that resolved after a ruptured coronary sinus aneurysm was patched.Tex Heart Inst J, 2013, 40(4):489-492.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment for Unruptured Aneurysm of the Sinus of Valsalva

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