A Review on the Surgical Management of Subvalvular Aneurysm

Abstract

The present perspective is a synthesis of published investigations in the setting of subvalvular aortic aneurysms. We identified 75 investigations and reviewed the clinical presentation, diagnostic modalities used, surgical techniques employed, and their outcomes. Clinical presentation, radiographic findings, transthoracic and transesophageal echocardiography, electrocardiogram-gated computerized tomography, and magnetic resonance imaging provided the diagnostic information and were used to define the disease entity before surgery. In this article, we have attempted to address several issues concerning establishment of diagnosis, varied clinical presentation, and their management. We submit that an increased appreciation of this disease entity will contribute to improved surgical management.

Multiple Sub Annular Aneurysm in a Young Girl

“…Surgical intervention is recommended for patients as therapy and prevention of future complication. 1) 2) 3) …”

Rare incidental findings of large congenital subvalvular aortic aneurysm in asymptomatic adults: To operate or not to operate? So far from lightness

“…Its management has been described in the literature, mainly in acquired SAA, pediatric, and/or symptomatic patients yet. 2 Taking into account the limited and dishomogenous cases, along with related outcomes described in the literature, 2 there is still no consensus for the management of the incidental large congenital SAA diagnosed in asymptomatic adults, even more if older patients, who practice normal physical activity, in the absence of daily intense physical exertion. In this setting, the only case associated with a conservative approach was recently reported, with the initial diagnosis at 62-year-old.…”

“…1 Some authors suggest surgical treatment for large SAA, irrespective of symptoms. 2 To note, reported overall early and late mortality for the symptomatic patients undergoing SAA repair were 14.8% and 4.3%, respectively, taking into account a number of biases related to incomplete reports of the known casistic. 2 Furthermore, the related follow-up periods are extremely variable and limited, ranging from 7 days to 29 months (median 19 months).…”

“…2 To note, reported overall early and late mortality for the symptomatic patients undergoing SAA repair were 14.8% and 4.3%, respectively, taking into account a number of biases related to incomplete reports of the known casistic. 2 Furthermore, the related follow-up periods are extremely variable and limited, ranging from 7 days to 29 months (median 19 months). 2 The management of large congenital SAA in asymptomatic adults remains controversial, needing to decide between surgical approach from one side, due to the potential risk of rupture, and conservative approach with a close follow-up from the other.…”

“…2 Furthermore, the related follow-up periods are extremely variable and limited, ranging from 7 days to 29 months (median 19 months). 2 The management of large congenital SAA in asymptomatic adults remains controversial, needing to decide between surgical approach from one side, due to the potential risk of rupture, and conservative approach with a close follow-up from the other. 1,2 A wider detailed literature report of cases could be useful, as well as a dedicated international register and/or forum for discussion might be considered.…”