title: Sinus of Valsalva aneurysm: a late complication after repair of ascending aortic dissection.
abstract: Surgical advances and the introduction of new more rapid and accurate diagnostic techniques have led to significant improvement in the survival of patients with aortic aneurysms. However, considerable long-term morbidity and mortality remains a concern. In the present study we report on the occurrence of sinus of Valsalva (SV) aneurysm after repair of the ascending aorta for aortic dissection as a significant long-term complication. Since transesophageal echocardiography (TEE) became available it has been used for the follow-up of 33 hospital survivors after ascending aortic replacement for a mean of 27 +/- 20 months. Those patients who received a valved conduit were excluded from this analysis. The aortic valve was conserved in 22 patients: 17 had a dissecting aneurysm involving the ascending aorta and 4 patients non-dissecting aneurysms. A sinus of Valsalva diameter > 45 mm was considered an aneurysm and was found in a total of 7 patients (33%), 5 being patients with aortic dissection. The overall reoperation rate on account of SV aneurysms was 24%. We conclude that SV aneurysm is a significant long-term complication of patients after repair of the ascending aorta. In the light of these results we have changed our operative policy of repair to include resorcin glue as a reinforcing agent or to perform more extensive repair.
authors.affiliation: Surgical Clinic II, University of Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Simon
authors.forename: A N
authors.initials: AN
authors.lastname: Owen
authors.forename: R
authors.initials: R
authors.lastname: Moidl
authors.forename: N
authors.initials: N
authors.lastname: Kupilik
authors.forename: A
authors.initials: A
authors.lastname: Anwari
authors.forename: M
authors.initials: M
authors.lastname: Grabenwoeger
authors.forename: M
authors.initials: M
authors.lastname: Ehrlich
authors.forename: W
authors.initials: W
authors.lastname: Mohl
authors.forename: E
authors.initials: E
authors.lastname: Wolner
authors.forename: M
authors.initials: M
authors.lastname: Havel
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000601:surgery*; D001014:Aortic Aneurysm / Q000209:etiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012850:Sinus of Valsalva