Ruptured sinus of valsalva aneurysm: early recurrence and fate of the aortic valve.
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.
Azakie
A
A
Division of Cardiovascular Surgery, The Toronto General Hospital, University of Toronto, Ontario, Canada.
David
T E
TE
Peniston
C M
CM
Rao
V
V
Williams
W G
WG
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