Clinical Profile and Management Options of Ruptured Sinus of Valsalva

  • Dr Supratim Sen, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
  • Dr Biswajit Bandyopadhyay, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
  • Dr Amitabha Chattopadhyay, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
  • Dr Mily Ray, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India

    • The first successful surgical repair of Rupture of aneurysm of the sinus of Valsalva (RSOV) was in 1957. It is now accepted that RSOVs are amenable to transcatheter device closure. We analyzed demographics and lesion characteristics of RSOV, and outcomes of surgical repair and device closures. Isolated RSOVs were closed by transcatheter device closure. Patients with RSOV associated with other lesions underwent surgical repair.

    Twenty-one patients presented to our institute with RSOV between January 2004 and January 2008. The mean age of presentation was 29.9 years. Aortic regurgitation and VSD were the commonest associated lesions. Eight patients with isolated RSOVs underwent device closure. The average hospital stay was 2.9 days as compared to 8.2 days for surgical repair. There were no mortalities and no significant short term complications in both the patients with surgical and device closures.

    We conclude that transcatheter device closure is a viable and safe treatment option for isolated RSOVs, whereas surgical repair is better suited for those patients with associated cardiac malformations.

    Origin RSOV Lesion Characteristics: Exit Site
    RA RV RVOT Total
    Right coronary sinus 2 3 11 16
    Non-coronary sinus 4 0 1 5
    Left coronary sinus 0 0 0 0
    Total 6 3 12 21