Giant sinus of valsalva aneurysm with severe aortic incompetence treated with a valve-sparing operation.
Typically, a sinus of Valsalva aneurysm with severe aortic incompetence is repaired with patch closure and aortic valve replacement. Here, we describe a very rare case of a giant nonruptured right Valsalva aneurysm, combined with severe aortic incompetence, treated with a valve-sparing aortic root replacement. During surgery we noted that the lengths of the free margin of the cusps and annuli were not uniform. As a result, we placed the first layer of sutures for the Valsalva graft in the same ratio as the annuli. It is difficult to preserve the geometry of the aortic annulus and position the commissures in the graft. One surgical tip for valve-sparing aortic root replacement for a sinus of Valsalva aneurysm with severe aortic incompetence is to suture the commissures inside the graft in the same ratio as the length of the cusp free margins.
Department of Cardiovascular Surgery, Heart Valve Center, Komaki City Hospital, Komaki-City, Aichi, Japan. sawamasa7007bb@nifty.com
Masaru
M
Sawazaki
Shiro
S
Tomari
Naoto
N
Izawa
D000328:Adult; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D012850:Sinus of Valsalva / Q000473:pathology*; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*