Ruptured Aneurysms of the Sinus of Valsalva

Morgan, James L.; Rogers, Albert K.; Fosburg, Richard G.

doi:10.1378/chest.61.7.640

Cited by 19 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, others propose that a combined approach offers more advantages. Thus meticulous closure of the fistula as well as effective myocardial protection via cardioplegic arrest may decreased the incidence of late aortic insufficiency [4,26,27]. However, with on-pump beating-heart surgery, the advantages offered by the combined approach were achieved using TEE.…”

Section: Discussionmentioning

confidence: 99%

Surgical correction of ruptured aneurysms of the sinus of Valsalva using on-pump beating-heart technique

Lin

2010

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundRupture of aneurysms of the sinus of Valsalva results in abrupt onset of congestive heart failure. On-pump beating-heart surgery may reduce cardiac impairment by maintaining coronary blood flow and avoiding cardioplegia. Herein, we report the operative correction of thirty-one patients of ruptured aneurysms of the sinus of Valsalva, using the on-pump beating-heart technique.MethodsThirty-one patients with ruptured aneurysms of the sinus of Valsalva underwent operative corrections using the on-pump beating-heart technique. In patients with fistula diameter less than 1 cm and no aortic regurgitation, the aorta was unclamped throughout cardiopulmonary bypass(CPB) while receiving antegrade heart perfusion. In remainder of patients, retrograde perfusion was used.ResultsAfter intracardiac manipulation was complete and the nasopharyngeal temperature was raised to 36-37°C, the patients were smoothly weaned off CPB. There were no early or late postoperative deaths. All patients were in New York Heart Association functional class I at follow-up (range, 0.5-1 year). Mild-to-moderate aortic valve regurgitation was observed in one patient. No recurrence of the left-to-right shunt from ruptured aneurysms of the sinus of Valsalva was observed.ConclusionsBeating heart on pump allows adequate examination of the aortic lesion under near-physiologic conditions, allows decrease in ischemia-reperfusion injury and potentially decreases the risk of serious or fatal rhythm disturbances. On-pump beating-heart technique for repair of ruptured aneurysm of sinus of Valsalva is feasible and promising. Antegrade heart perfusion is suitable for patients with a fistula diameter <1 cm and no aortic regurgitation, and retrograde perfusion is suitable for the others.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical correction of ruptured aneurysms of the sinus of Valsalva using on-pump beating-heart technique

Lin

2010

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…It has been reported that, in some cases, the demonstration of a shunt in either right-sided chamber is not itself evidence of a ruptured aneurysm. Even in a case whose aneurysm ruptures into the right ventricle, aneurysmal protrusion into the right atrium across the tricuspid valve and/or tricuspid regurgitation can cause a rise in oxygen satu ration in the right atrium [4], The most fre quent cause of tricuspid regurgitation is dis tortion or deformity of the tricuspid valve due to aneurysmal involvement of the tricus pid. Tricuspid regurgitation is also caused by tricuspid ring dilation due to cardiac failure and perforation of the tricuspid valve com plicated by infectious endocarditis [5,6].…”

Section: Discussionmentioning

confidence: 99%

Rupture of an Aneurysm of the Aortic Sinus of Valsalva into the Right Ventricle

Anzai¹,

Yamada²,

Tuchida³

et al. 1987

Cardiology

View full text Add to dashboard Cite

Rupture of an aneurysm of the aortic sinus of Valsalva into the right ventricle is described. Surgery revealed a small aneurysm ruptured into the right ventricle near the tricuspid valve without aneurysmal involvement of the tricuspid valve. The cineangiogram revealed a shunt from the aortic sinus into the right atrium not during systole but during diastole, and increased oxygen saturation was found in the right atrium. The unusual hemodynamics in this case was most probably due to the closure of the small aneurysmal opening due to myocardial contraction during systole, so that the shunt flow through the aneursymal tract occurred only during diastole and was directed toward the right atrium due to the location of the aneurysm. Thus, even without aneurysmal involvement of the tricuspid valve or tricuspid regurgitation, the oxygen saturation increased in the right atrium.

show abstract