Rupture Sinus of Valsalva - Surgical Management -Single Surgeon Experience in 30 Years

The sinus of Valsalva aneurysm (SVA) is a dilatation caused by a separation between the aortic media and annulus fibrosus. Its origin may be either acquired or congenital. The right coronary sinus is most frequently affected, with the most common complication being rupture. The malformation consists of a separation or lack of fusion between the media of the aorta and the annulus fibrosis of the aortic valve. The structure becomes aneurysmal and may rupture to form a fistula. Indeed, a deficiency of normal elastic tissues and abnormal development of the bulbus cordis have been associated with the development of SVA. Material and methods: This is a retrospective study done during a period of 30 years from 1990 to 2020 nearly 38 cases of ruptured sinus of valsalva were encountered in various institutions by a single surgeon. The surgical results of the different approaches in each respective type were compared as follows: cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, intensive care unit time and postoperative stay time. Results: All the patients diagnosed as Ruptured sinus of valsalva were repaired surgically under cardiopulmonary bypass. There were 2 post operative deaths. All other patients who underwent repair were recovered well and were discharged. There were no significant differences in intensive care unit time and postoperative stay time among different approaches in each type (P greater than 0.05). Conclusions: The surgical repair of the rupture sinus of valsalva aneurysms exhibited good long term results. Unruptured sinus of Valsalva aneurysms without coexisting cardiac pathology, are generally followed closely without surgical intervention. Patients who have successfully undergone sinus of valsalva repair are expected to have normal life expectancy.