Transcatheter closure of a ruptured sinus of valsalva aneurysm.
BACKGROUND
Ruptured sinus of Valsalva aneurysms (RSVA) can be associated with ventricular septal defects or isolated lesions. Surgical repair has been the traditional treatment of for the RSVA. The results of transcatheter closure of the RSVA in 4 patients are reported.


RESULTS
From 2003 to 2004, 4 patients (2 males and 2 females) aged from 18 years to 47 years with RSVA were identified. The diagnosis of RSVA was made based on a combination of several imaging modalities. The drainage site of the RSVA was right ventricle in 2, and right atrium in remaining 2. All patients underwent general anesthesia and transesophageal echocardiographic (TEE) monitoring during the procedure. Transcatheter closure with an Amplatzer duct occluder was attempted in all 4 patients. The size of the Amplatzer duct occluder selected was up to 2 mm larger than the maximal diameter of the aortic opening site of the RSVA as measured on TEE images. The attempt to deploy an Amplatzer duct occluder was successful in 3 and a Gianturco coil was deployed in 1. Follow-up (3-18 months) echocardiography showed neither residual shunt nor aortic regurgitation in any of the patients.


CONCLUSIONS
The transcatheter technique is a safe alternative in the treatment of RSVA; however, a longer follow-up is mandatory.
Chang
Chi-Wei
CW
Department of Pediatrics, National Taiwan University Hospital, School of Medicine, National Taiwan University.
Chiu
Shuenn-Nan
SN
Wu
En-Ting
ET
Tsai
Shen-Kou
SK
Wu
Mei-Hwan
MH
Wang
Jou-Kou
JK
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy*; D021721:Balloon Occlusion; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012850:Sinus of Valsalva / Q000473:pathology* / Q000601:surgery