Surgical Reconstruction of Valsalva Sinus Aneurysms: One Surgical Team Outcomes from Tertiary Center

Abstract

Background: There are many surgical methods used to treat sinus of Valsalva aneurysms, and these methods vary depending on the surgical team's expertise and the patient's health, which has an impact on the surgical outcomes. Objectives: In our study, we evaluated the midterm outcomes of a single center's highly skilled surgical team. Methods: In this retrospective cohort study the clinical data of 42 consecutive patients from November 1, 2005 to 21 august 2018 were reviewed and early and mid-term results were assessed. Twenty-two patients (53%) were presented with ruptured aneurysms; 8 of these patients (28.5%) had their aneurysms repaired with a double patch and an AV repair; nonetheless, 20 patients (46.6%) required valve replacement. Results: It was found that there was no bicuspid valve in our patients, no correlation between the presence of VSD and the severity of aortic insufficiency in our series (P = 0.89), and the severity of aortic insufficiency increased when the Valsalva aneurysm ruptured into the heart chambers. There was a strong association between female gender and ruptured sinus of Valsalva aneurysms (P = 0.02, AI severity, P = 0.05, aortic valve surgery, P = 0.03, and total AV replacement, P = 0.001). RSOV and the likelihood of a heart block did not correlate in our series (P = 0. 29). Conclusions: Results from one surgical team, particularly when the same specialist is making decisions, are more trustworthy. Excellent long-term outcomes are obtained, and rupture of the SOV is linked to an increase in AI and, ultimately, to aortic valve surgery, primarily AV replacement. Using patch technique for closing fistulas does not increase the post op arrhythmia.