Surgical Treatment of Ruptured Aneurysm of Sinus of Vasalva.
- Author:
Joung Taek KIM
1
;
Byung Chul CHANG
;
Meyun Shick KANG
;
Bum Koo CHO
;
Sung Nok HONG
Author Information
1. Department of Cardio-Thoracic Surgery, Inha University Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Sinus of Valsalva;
Endocarditis;
Aortic valve
- MeSH:
Aneurysm, Ruptured*;
Aortic Valve;
Aortic Valve Insufficiency;
Coronary Sinus;
Endocarditis;
Follow-Up Studies;
Freedom;
Humans;
Risk Factors;
Sinus of Valsalva;
Survival Rate
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1997;30(6):607-612
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Between March 1963, and December 1994, fifty-three patients with a ruptured aneurysm of sinus of Vasalva(RSV) were operated. The RSV originated from the right coronary sinus in 43 patients(81%), from the non coronary sinus in 7 patients(13%), and from combined sinuses in 2 patients. The RSV from the right coronary sinus mainly drained to the right ventricle(81.4%), and the RSV from the non coronary sinus mainly drained to the right atrium(71.4%). Recently, we are using patch to repair the RSV through a double approach. During the operation, concomitant procedures were performed; 32 Patch repairs of VSD, 14 aoric valvuloplasty, 10 aortic valve replacement, 2 tricuspid valvuloplasty, and one Bentall's procedure. During the follow up period between 1 and 31 years(mean 8 years, 94% follow up), there were 2 late deaths and 14 late complications. Actuarial 10-year survival rate was 95%, and 10-year actuarial freedom from late event was 53 %. Factor analysis revealed that the combined SBE is a risk factor of late event. Actuarial freedom from failure of aortic valvuloplasty was 55% at 9 years. Although surgical repair of RSV achieved excellent long term survival, aortic regurgitation and endocarditis revealed significant risk factor in long-term results. Therefore, more attention should be required in patients of RSV associated with aortic regurgitation or endocarditis.
