title: Emergency surgery for ruptured sinus of Valsalva aneurysms.
abstract: OBJECTIVE
  A ruptured sinus of Valsalva aneurysm is a very rare cardiac anomaly. Successful repair of these aneurysms was first described in the late 1950s. Several approaches for repair, through the aortic root or the chamber into which the aneurysm ruptures or a combination of both, have been described. We present our experience with emergency surgical repair of ruptured sinus of Valsalva aneurysms and our current surgical policy.
  
  
  METHODS
  A review of the St. Antonius Hospital database from January 1972 to December 2010 identified a total of 16 patients. A retrospective review of their medical records and telephonic follow-up was performed.
  
  
  RESULTS
  Fifteen patients (13 male, three female) aged 46 ? 13 years were operated. The ruptured aneurysm arose from the right coronary (63%) and non-coronary sinus (37%) and ruptured into the right ventricle (67%) and into right atrium (33%). Primary suture closure was done in six patients and patch closure was performed in the remaining 10 patients. No intra-operative death occurred. Long-term follow-up identified one recurrent fistula from right coronary sinus to right atrium 28 years after primary suture closure.
  
  
  CONCLUSIONS
  We performed prompt surgical repair of the ruptured sinus of Valsalva aneurysm preferably with a patch.
authors.affiliation: Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. geoffrey_kloppenburg@hotmail.com
authors.forename: Geoffrey T L
authors.initials: GT
authors.lastname: Kloppenburg
authors.forename: Uday
authors.initials: U
authors.lastname: Sonker
authors.forename: Marco C
authors.initials: MC
authors.lastname: Post
authors.forename: Alaaddin
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Morshuis
mesh_terms: D000328:Adult; D000368:Aged; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D017548:Echocardiography, Transesophageal; D004630:Emergencies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult