title: Ruptured sinus of valsalva aneurysm: early recurrence and fate of the aortic valve.
abstract: BACKGROUND
  We reviewed our experience with congenital ruptured sinus of Valsalva aneurysms (RSVA) to determine patterns of early recurrence and the fate of the aortic valve (AV).
  
  
  METHODS
  Over a 28-year period, RSVA was identified in 34 patients, (mean age 31.6 years). Primary closure of the RSVA was performed in 10 patients, and a patch employed in 24. Aortic insufficiency was present in 24 patients. AV replacement (AVR) was performed in 5 patients; AV repair in 6.
  
  
  RESULTS
  Follow-up of 9.2 +/- 8.3 years (6 months to 24 years) was complete in all but 2 patients. Five early fistula recurrences (in 4 patients) correlated with primary rather than patch closure (p < 0.03). Kaplan-Meier survival at 10 years is 90 +/- 7%. Freedom from reoperative AVR at 10 years is 83 +/- 9%. Late AVR was performed in 6 patients for progressive aortic insufficiency due to bicuspid valve (n = 3), cusp disease of affected sinus (n = 2), or aortic root dilatation (n = 2).
  
  
  CONCLUSIONS
  Patch closure of the RSVA should be routinely employed. A bicuspid valve may be associated with the late need for AVR.
authors.affiliation: Division of Cardiovascular Surgery, The Toronto General Hospital, University of Toronto, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Azakie
authors.forename: T E
authors.initials: TE
authors.lastname: David
authors.forename: C M
authors.initials: CM
authors.lastname: Peniston
authors.forename: V
authors.initials: V
authors.lastname: Rao
authors.forename: W G
authors.initials: WG
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001014:Aortic Aneurysm / Q000151:congenital* / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000151:congenital* / Q000401:mortality / Q000601:surgery*; D001021:Aortic Valve / Q000502:physiology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012008:Recurrence; D012850:Sinus of Valsalva; D015996:Survival Rate; D016896:Treatment Outcome