Standby Surgical Repair for Ruptured Sinus of Valsalva Aneurysm in an Elderly Patient: a Case Report and Literature Review
- VernacularTitle:待機的治療が可能であった高齢者Valsalva洞動脈瘤破裂の1例
- Author:
Tadashi UMENO
1
;
Hirotsugu HAMAMOTO
1
;
Shinji MIYAMOTO
2
Author Information
- Keywords: sinus of Valsalva aneurysm; rupture into the right atrium; standby surgical repair; aortic insufficiency
- From:Japanese Journal of Cardiovascular Surgery 2024;53(4):198-202
- CountryJapan
- Language:Japanese
- Abstract: This case study reports the case of a 72-year-old man who was diagnosed with aortic regurgitation 20 years ago after a medical checkup and received treatment for edema and weight gain for approximately 2 months at the local hospital. The patient was diagnosed with a ruptured Valsalva aneurysm in the noncoronary sinus with right atrium shunting. Two and a half months after the onset, surgical repair was scheduled on a standby basis, and the patient was discharged 14 days postoperatively with a good course. The surgery was completed with fistula closure using a patch via the aortic valve and the right atrial side approaches as well as aortic valve replacement for aortic regurgitation due to uncinate valve leaflet degeneration. The ruptured sinus of the Valsalva aneurysm is an extremely rare disease, which forms a left-to-right shunt that progresses to severe heart failure. Moreover, congenital tissue fragility of the sinus of Valsalva causes this pathogenesis, and rupture prevalently occurs at a relatively young age, up to approximately 40 years. Herein, after a thorough literature review, we report an extremely rare case of an elderly onset at 72 years of age, and a rare disease course in which elective surgery could be performed without rapid heart failure progression.
