Surgical treatment of dissecting aneurysm of the interventricular septum.
OBJECTIVE
We reviewed our experience in the surgical treatment of an extremely rare disease, dissecting aneurysm of the interventricular septum (DAIS). The definition of DAIS is that the interventricular septum is dissected and forms an aneurysm which bulges into both the left and right ventricles, causing obstruction of both ventricular outflow tracts. It communicates with the aortic root, and may communicate with the ventricle. It is usually associated with aortic valve regurgitation and aortic annular enlargement. DAIS might also be related to the sinus of Valsalva aneurysm [Ann Thorac Surg 65 (1998) 735; Ann Thorac Surg 51 (1991) 996; Eur J Thorac Surg 12 (1997) 759]. But in three of our six patients DAIS was not associated with sinus of Valsalva enlargement or aneurysm.


METHODS
Between May 1992 and November 2000, six of 30,701 patients were diagnosed with DAIS, and underwent surgery at Fu Wai Hospital in Beijing. Aortic valve replacement was performed in five patients, and the perforation at the bottom of the right sinus of Valsalva was repaired in one. The aneurysm was resected simultaneously in all these patients.


RESULTS
One of the six patients required re-operation. And all patients recovered uneventfully without hospital mortality.


CONCLUSIONS
DAIS has a progressive course and poor prognosis. Early diagnosis and surgical treatment are mandatory.
Wu
Qingyu
Q
Department of Cardiac Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China. wuqingyu@public.bta.net.cn
Xu
Jianping
J
Shen
Xiangdong
X
Wang
Dongjin
D
Wang
Shuiyun
S
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001021:Aortic Valve; D005260:Female; D006322:Heart Aneurysm / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012850:Sinus of Valsalva / Q000601:surgery