Department of Cardiovascular and Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Card Surg. 2021 Apr;36(4):1264-1269. doi: 10.1111/jocs.15358. Epub 2021 Jan 21.
Untreated ruptured sinus of Valsalva aneurysms ultimately develop into heart failure, thereby affecting patients' survival. We retrospectively analyzed our 13-year experience of the surgical repair for ruptured sinus of Valsalva aneurysm to study the optimal surgical strategy, operative risk and long-term surgical outcome.
Twenty-six patients underwent surgical repair of ruptured sinus of Valsalva aneurysm from January 2008 to February 2020. Follow-up data were obtained from the outpatient department records and telephone calls.
Patch closure of ruptured sinus of Valsalva aneurysm was done in all the 26 patients, most often through the transaortic (69%) and dual-chamber approach (23%). Aortic valve repair was done in one patient while seven patients underwent aortic valve replacement for associated significant aortic regurgitation. There was one in-hospital mortality because of noncardiac cause. The median duration of postoperative hospital stay was 8 days (range, 6-11 days). Follow-up data were available for 89% (23/26) patients. The mean follow-up period was 69 ± 43 months (range, 7-147 months). All survivors were in New York Heart Association functional Class I or II. There was no late death. One patient required rehospitalization for recurrent ruptured sinus of Valsalva aneurysm. There was no recurrent or new-onset significant aortic regurgitation and prosthesis-related complications in late follow-up.
Surgical repair for ruptured sinus of Valsalva aneurysm carries an acceptable low operative risk and excellent long-term outcome. Though high-risk population, an early diagnosis and optimal surgical approach can prevent worsening of symptoms and consequent heart failure.
未经治疗的瓦氏窦破裂性动脉瘤最终会发展为心力衰竭，从而影响患者的生存。我们回顾性分析了 13 年来手术修复瓦氏窦破裂性动脉瘤的经验，以研究最佳手术策略、手术风险和长期手术结果。
2008 年 1 月至 2020 年 2 月，26 例瓦氏窦破裂性动脉瘤患者接受手术修复。通过门诊记录和电话获得随访数据。
26 例患者均行瓦氏窦破裂性动脉瘤修补术，最常采用经主动脉（69%）和双房入路（23%）。1 例患者行主动脉瓣修复术，7 例患者因合并严重主动脉瓣反流而行主动脉瓣置换术。1 例患者因非心脏原因住院死亡。术后住院时间中位数为 8 天（范围 6-11 天）。89%（23/26）患者获得随访数据。平均随访时间为 69±43 个月（范围 7-147 个月）。所有幸存者心功能均处于纽约心脏协会功能 I 级或 II 级。无晚期死亡。1 例患者因再次发生瓦氏窦破裂性动脉瘤而再次住院。晚期无复发性或新发严重主动脉瓣反流及假体相关并发症。
手术修复瓦氏窦破裂性动脉瘤的手术风险低，长期效果好。尽管是高危人群，但早期诊断和最佳手术方法可以预防症状恶化和随后的心力衰竭。
