Wingo Matthew, de Angelis Paolo, Worku Berhane M, Leonard Jeremy R, Khan Faiza M, Hameed Irbaz, Lau Christopher, Gaudino Mario, Girardi Leonard N
Department of Cardiothoracic Surgery, Weil Cornell Medicine, New York, New York.
J Card Surg. 2019 Jun;34(6):400-403. doi: 10.1111/jocs.14041. Epub 2019 Apr 6.
Sinus of Valsalva (SOV) aneurysms are rare and data on operative management are limited. They can cause right ventricular outflow tract or pulmonary artery compression, and rupture may be fatal. In this study, we describe our experience with the repair of 13 SOV aneurysms.
All patients who underwent SOV aneurysm repair from May 2001 to December 2017 at our single tertiary referral center were reviewed retrospectively.
Thirteen patients (92% male) with a mean age of 60 years underwent repair of an SOV aneurysm; mean aneurysm diameter was 5.9 ± 0.8 cm and four patients (30.7%) presented with rupture into another cardiac chamber. Operative interventions included six Bentall procedures, five patch repairs (one with aortic valve replacement [AVR]), and two primary aneurysm closures both with concomitant AVR. There were no strokes, myocardial infarctions, re-explorations, or deaths in the postoperative period. After an average of 2.25 years, computed tomographic imaging in five patients demonstrated no aneurysm recurrence.
Surgery is a safe option for both ruptured and nonruptured SOV aneurysms. A variety of repair strategies may be used. Larger studies are needed.
主动脉瓣窦（SOV）瘤较为罕见，关于其手术治疗的数据有限。它们可导致右心室流出道或肺动脉受压，破裂可能致命。在本研究中，我们描述了我们修复13例SOV瘤的经验。
回顾性分析2001年5月至2017年12月在我们单一的三级转诊中心接受SOV瘤修复的所有患者。
13例患者（92%为男性）平均年龄60岁，接受了SOV瘤修复；平均瘤体直径为5.9±0.8cm，4例患者（30.7%）出现瘤体破裂至另一个心腔。手术干预包括6例Bentall手术、5例补片修复（1例同时行主动脉瓣置换术[AVR]）以及2例均同时行AVR的原发性瘤体闭合术。术后无卒中、心肌梗死、再次手术或死亡病例。平均2.25年后，5例患者的计算机断层扫描成像显示无瘤体复发。
手术对于破裂和未破裂的SOV瘤都是一种安全的选择。可采用多种修复策略。需要开展更大规模的研究。
