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Ann Thorac Surg 1988;46:515-519
© 1988 The Society of Thoracic Surgeons

Articles

15- to 30-Year Follow-up of Patients Undergoing Repair of Ruptured Congenital Aneurysms of the Sinus of Valsalva

Thomas P. Barragry, M.D.*, W. Steves Ring, M.D., James H. Moller, M.D., C. Walton Lillehei, Ph.D., M.D.

Department of Surgery, University of Minnesota, and Variety Club Heart Hospitals, Minneapolis, MN

Accepted for publication May 3, 1988.

* Address reprint requests to Dr. Barragry, University of Minnesota Hospitals and Clinics, Box 35 UMHC, 420 Delaware St, SE, Minneapolis, MN 55455

Rupture of a congenital aneurysm of the sinus of Valsalva is a rare congenital cardiac malformation. Between 1956 and 1971, we operated on 14 patients aged 9 to 36 years (median, 20 years) for repair of a ruptured aneurysm of the sinus of Valsalva, and have followed each patient to the present. Two operative and 4 late deaths occurred, 3 following a second cardiac operation and the other from dysrhythmia. Late complications have included development of complete heart block in 2 patients (necessitating permanent pacemaker insertion 11 and 24 years after initial repair), progression of aortic regurgitation in 2 (necessitating valve replacement 9 and 13 years after initial repair), and endocarditis in 1 patient 20 years after repair. Four of the 8 remaining long-term survivors (followed for 15 to 30 years [mean, 23.6 years]) are in New York Heart Association (NYHA) Class 1, and the other 4 are in NYHA Class II. Three of the 5 patients with suture closure (no pledgets or adjacent ventricular septal defect repair) of the ruptured aneurysm of the sinus of Valsalva sustained recurrent rupture and required repeat closure. Whether the lack of prosthetic material to bolster the repair or inadequate resection of redundant aneurysmal fibrous tissue was responsible for these recurrences cannot be stated. Operative management of patients with ruptured congenital aneurysms of the sinus of Valsalva is discussed.




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