Peratrial Device Closure of Ruptured Sinus of Valsalva Aneurysm Into Right Atrium

Transthoracic minimally invasive closure for the treatment of ruptured sinus of Valsalva aneurysm: immediate and mid-term follow-up results

“…Moreover, PCC is difficult to convert to surgical repair when closure fails and cannot be performed for some patients with a prior history of allergies to contrast media. In contrast, transthoracic closure under TEE guidance can not only clearly define the anatomy of the RSVA and its adjacent structures, but can also shorten the delivery pathway and enable the occluder to be released easily in a more stable position, similar to findings reported by Liang et al (25). In addition, the procedure can easily be converted to surgical repair if the closure fails.…”

“…The selection of a suitable occluder is important for the efficacy of percutaneous closure of RSVA; however, no occluders have yet been specially designed for this rare anomaly. At present, VSD occluders and PDA occluders are J Thorac Dis 2022;14 ( the most frequently used for the closure of RSVA in most reports (15,22,25). The effectiveness of the closure is not only dependent on aneurysm size but also on the relationship of the aneurysm with the adjacent structures and the shape of the RSVA.…”

“…The effectiveness of the closure is not only dependent on aneurysm size but also on the relationship of the aneurysm with the adjacent structures and the shape of the RSVA. Since the shape of the RSVA under TEE was either a "windsock" or funnel-shaped deformity, the PDA occluder or muscular VSD occluder was considered to be best suited for this defect (25). A ductal occluder or a muscular VSD occluder should be chosen for a windsock RSVA, while a small-waist double disk or muscular VSD occluder might be chosen for a funnel-shaped RSVA with a long or short aortic rim.…”