Original ArticlesSinus of valsalva aneurysm or fistula: management and outcome
Section snippets
Material and methods
We reviewed the hospital records and postoperative clinical charts of 129 consecutive patients with 149 SVAFs treated at our institution between April 1956 and January 1997. When necessary, supplemental information was obtained from the patient’s private cardiologist and family.
The series included 88 men (68.2%) and 41 women (31.8%), whose average age at operation was 39.1 years (range 2 to 74 years). With respect to New York Heart Association functional status, 8 patients were in class I
Results
Perioperative adverse events included five in-hospital deaths (3.9%): four (3.1%) that were secondary to preexisting sepsis and endocarditis, and one (0.8%) that followed dehiscence of the primary repair in a patient with Marfan’s syndrome. Two patients (1.6%) had strokes but completely recovered their neurologic function before being discharged from the hospital. All 124 survivors were symptom free at hospital discharge.
The late follow-up period totaled 661.1 patient-years (5.3 years/patient).
Comment
Because of the relative infrequency of SVAFs, investigators have not accurately determined the natural history of these lesions. Abbott [11] and Edwards and Burchell [12] have provided evidence of a congenital etiology. They have suggested that the lesion is due to a structural deficiency in the media related to the development of the distal bulbar septum 11, 12. Others have described an “acquired” etiology, marked by degeneration of the media secondary to syphilis [7], infection [13],
References (26)
- et al.
Direct vision intracardiac surgery in man using a simple, disposable artificial oxygenator
Dis Chest
(1956) - et al.
Aneurysm and fistula of the sinus of Valsalvaclinical considerations and surgical treatment in 45 patients
Ann Thorac Surg
(1975) - et al.
Isolated nonruptured sinus of Valsalva aneurysmserendipitous detection and correction
J Thorac Cardiovasc Surg
(1975) - et al.
Congenital aneurysm of the sinus of Valsalva protruding into the left ventriclereview of diagnosis and treatment of the nonruptured aneurysm
J Thorac Cardiovasc Surg
(1976) - et al.
Ruptured aneurysms of the sinus of Valsalva in Oriental patients
J Thorac Cardiovasc Surg
(1990) Aneurysms of the aortic sinuses of Valsalva due to bacterial endocarditis, with special reference to their operative management
J Thorac Cardiovasc Surg
(1972)- et al.
Abnormalities of the sinuses of Valsalvaexperience with 35 patients
J Thorac Surg
(1967) - et al.
Asymptomatic sinus of Valsalva aneurysm causing right ventricular outflow obstruction before and after rupture
Am J Cardiol
(1984) - et al.
Ventricular tachycardia secondary to aneurysm of sinus of Valsalva
J Thorac Cardiovasc Surg
(1979) - et al.
Congenital aneurysm of the left sinus of Valsalvareport of a patient with 19-year survival without surgery
Chest
(1986)
Ruptured aneurysms of the sinus of Valsalva
Ann Thorac Surg
Comparison of bioprosthetic and mechanical valve replacement for active endocarditis
J Thorac Cardiovasc Surg
Isolated extracardiac nonruptured sinus of Valsalva aneurysms
Ann Thorac Surg
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