title: Long-term outcomes of transcatheter closure of ruptured sinus valsalva aneurysms using patent ductus arteriosus occluders.
abstract: BACKGROUND
  Transcatheter closure (TCC) of ruptured sinus of Valsalva aneurysm (RSVA) is an alternative strategy to surgery, but there is a lack of long-term outcome data. METHODS AND RESULTS: From 2004 to 2012, 17 patients (8 males, 9 females) were treated with patent ductus arteriosus (PDA) occluders by antegrade venous approach and were followed for 18-102 months. Of the 17 patients, transthoracic echocardiography revealed rupture of the right coronary sinus into the right ventricle in 9 and into the right atrium in 4, and noncoronary sinus rupture into the right ventricle in 3 and into the right atrium in 1. Most (10/17) were in New York Heart Association (NYHA) functional class III or IV. Aortography showed that the size of the defect was 7.71±2.84 mm (4-15 mm). TCC was attempted using PDA occluders 2-5 mm larger than the aortic end of the defects. The device sizes ranged from 8/6 to 18/16 mm (median, 10/8 mm). The procedure was successful in 16 (94.1%), and all of them had complete occlusion at discharge. On a median follow-up of 42 months, 14 patients were in NYHA class I and 2 were in class II, and there was no residual shunt, device embolization, infective endocarditis, or aortic regurgitation.
  
  
  CONCLUSIONS
  TCC of RSVA is a safe and effective alternative to surgery with favorable long-term follow-up results.
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital of Central South University.
authors.forename: Zhen-Fei
authors.initials: ZF
authors.lastname: Fang
authors.forename: Yi-Yuan
authors.initials: YY
authors.lastname: Huang
authors.forename: Liang
authors.initials: L
authors.lastname: Tang
authors.forename: Xin-Qun
authors.initials: XQ
authors.lastname: Hu
authors.forename: Xiang-Qian
authors.initials: XQ
authors.lastname: Shen
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Tang
authors.forename: Sheng-Hua
authors.initials: SH
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D001019:Aortic Rupture / Q000209:etiology / Q000473:pathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000473:pathology / Q000601:surgery; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012850:Sinus of Valsalva / Q000473:pathology / Q000601:surgery