Choudhary S K, Bhan A, Sharma R, Airan B, Kumar A S, Venugopal P
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
J Card Surg. 1997 Sep-Oct;12(5):300-8. doi: 10.1111/j.1540-8191.1997.tb00143.x.
Aneurysms of sinus of Valsalva are rare. Here, we analyze retrospectively patients operated on at our center during the last 20 years.
One hundred four cases of congential aneurysm of sinus of Valsalva were operated upon between January 1977 and April 1996. Only 12 aneurysms were unruptured. The majority (76.9%) arose from the right coronary sinus. The right ventricle was the most common chamber of rupture (58.6%). Ventricular septal defect was associated in 46 patients (44.2%), of which 28 (60.9%) were supracristal. Ventricular septal defect was more common in aneurysms arising from the right coronary sinus (91.3%). Aortic incompetence was found in 45 patients (43.3%). The defect was closed through the aortic root alone in 24 patients (23.1%) and through both the aortic root and the chamber of rupture in the remaining 80 patients. Six patients underwent aortic valve repair, and 21 an aortic valve replacement.
There were two hospital deaths (1.92%). Morbidities were few. Follow-up ranged from 1 to 20 years (mean 8.2 +/- 1.1). There was one late noncardiac death, and in the majority, the long-term follow-up was uneventful.
Surgery for aneurysm of sinus of Valsalva yields gratifying results, and it should be undertaken as soon as the condition is diagnosed.
瓦尔萨尔瓦窦瘤动脉瘤较为罕见。在此，我们回顾性分析了过去20年在我们中心接受手术的患者。
1977年1月至1996年4月期间，对104例先天性瓦尔萨尔瓦窦瘤动脉瘤患者进行了手术。仅12例动脉瘤未破裂。大多数（76.9%）起源于右冠状动脉窦。右心室是最常见的破裂腔室（58.6%）。46例患者（44.2%）合并室间隔缺损，其中28例（60.9%）为嵴上型。室间隔缺损在起源于右冠状动脉窦的动脉瘤中更为常见（91.3%）。45例患者（43.3%）发现主动脉瓣关闭不全。24例患者（23.1%）仅通过主动脉根部关闭缺损，其余80例患者通过主动脉根部和破裂腔室关闭缺损。6例患者接受了主动脉瓣修复，21例接受了主动脉瓣置换。
有2例医院死亡（1.92%）。并发症较少。随访时间为1至20年（平均8.2±1.1）。有1例晚期非心脏死亡，大多数患者长期随访情况良好。
瓦尔萨尔瓦窦瘤动脉瘤手术效果令人满意，一旦确诊应尽早进行手术。
