Transcatheter closure of a ruptured sinus of valsalva: a systematic review of the literature

Abstract

BackgroundRuptured sinus of Valsalva (RSOV) is a rare pathology, and current data regarding its symptoms, anatomy, associated pathologies, and appropriate therapeutic approaches are scarce. Transcatheter closure (TCC) has been performed in multiple cases; however, the information on its success rate and complications is limited.MethodsTwo independent reviewers performed an advanced search based on inclusion criteria on Scopus, PubMed, and Embase from January 1985 through July 2022. The main search terms were “Sinus of Valsalva”, “Rupture/Aneurysm”, and “Transcatheter/Catheter/Device”.ResultsTotally, 1,017 relevant articles from the 3 databases were retrieved. After the final review and appraisal, 94 articles describing 407 patients who underwent the TCC of RSOV were included. Males comprised 65% of the studied patients, and the average age was 34.5 years. The total success rate of TCC was 95.6%. Forty-nine patients (12%) developed complications, the most significant of which were sustained residual shunts in 7 patients (1.7%), substantial new onset or progression of aortic insufficiency in 6 (1.5%), and RSOV recurrence in 6 (1.5%). Post-interventional mortality was reported in only 2 patients (0.5%).ConclusionsThe present study is the first systematic review of available data regarding the TCC of RSOV principally comprising case series and case reports. Although TCC seems a good option, precise patient selection is mandatory.

Sinus of Valsalva Aneurysm: Different Modes of Presentation and Techniques of Repair

“…Both methods showed similar and low postoperative residual shunts and aortic regurgitation [11]. The second review analyzed the transcatheter method in 407 patients: the success rate of the trancatheter closure was 95.6% with an overall mortality of 0.5%, but 12% of the patients developed complications, the most significant of which were sustained residual shunts in seven, substantial new onset or progression of aortic insufficiency in six and recurrence of SVA in six [12].…”