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Clinical features and surgical results of ruptured sinus of valsalva aneurysm

Korean Journal of Pediatrics 2006;49(3):287-291.
Published online March 15, 2006.
Clinical features and surgical results of ruptured sinus of valsalva aneurysm
Tae Ho Lee1, Dong Won Lee1, Joon Yong Cho2, Myung Chul Hyun1, Sang Bum Lee1
1Department of Pediatrics, College of Medicine, Kyungbook National University, Daegu, Korea
2Department of Thoracic Cadiovascular Surgery, College of Medicine, Kyungbook National University, Da
발살바동 동맥류 파열의 임상적 고찰
이태호1, 이동원1, 조준용2, 현명철1, 이상범1
1경북대학교 의과대학 소아과학교실
2경북대학교 의과대학 흉부외과학교실
Correspondence: 
Myung Chul Hyun, Email: mchyun@knu.ac.kr
Abstract
Purpose
: Aneurysms of sinus valsalva are rare anormalies thought to be primarily congenital in origin, progressing into death by acute heart failure in cases of rupture. Surgical correction is the only method of treatment. With these clinical implications, we reviewed the clinical characteristics and surgical results of patients with ruptured sinus of valsalva aneurysm.
Methods
: Between January 1991 and February 2004, 17 patients with ruptured sinus of valsalva aneurysm were retrospectively reviewed for their clinical symptoms, physical findings, past history, coexistent cardiac anormalies, surgical results, and mid-term prognosis.
Results
: The 17 patients included 13 men and four women, with a mean age of 30 years(10-59 years). Preoperatively accompanying cardiac anormalies were ventricular septal defect(VSD, eight cases of doubly committed juxta-arterial VSD) and aortic insufficiency(11 cases). During operations, patterns of fistulous tracts were found to be right colonary sinus-right ventricle in 13 patients, right coronary sinus-right atrium in one, noncoronary sinus - right ventricle in two, noncoronary sinus - right atrium in one, and VSD was noticed in 14 patients(all were doubly committed juxta-arterial in type). The defects were closed with a patch in 13 patients, without a patch in four, with concommitant aortic valve replacement in four and with aortic valvuloplasty in two. There were no mortalities during operations or the mid-term follow-up periods(40¡¾49 months).
Conclusion
: Because, at least in Orientals, VSD(especially doubly committed juxta-arterial) was accompanied in large numbers of patients with aneurysms of sinus valsalva, preoperative evaluations of this congenital heart disease should be made very careful. And we may need to revise the algorithm of treatment policy in small sized doubly committed juxta-arterial VSD.
Key Words: Ruptured sinus of valsalva aneurysms, Congenital heart disease


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