Journal
JOURNAL OF THORACIC DISEASE
Volume 14, Issue 1, Pages 169-176Publisher
AME PUBL CO
DOI: 10.21037/jtd-22-32
Keywords
Ruptured sinus of Valsalva aneurysm (RSVA); congenital heart disease; transesophageal echocardiography (TEE); minimally invasive; closure
Categories
Funding
- youth fund of the Cuiying Science and Technology Innovation program ofLanzhou University Second Hospital [CY2019-QN12]
- Health Industry Research Program of Gansu Provincial [GSWSKY-2019-77]
- Youth Science and Technology Fund of Gansu Province [21JR1RA164]
- Innovation Fund for Higher Education of Gansu Province [2020B-037]
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This study evaluated the immediate and mid-term outcomes of transthoracic minimally invasive closure (TMIC) in patients with ruptured sinus of Valsalva aneurysm (RSVA). The results showed that TMIC had a high technical success rate and showed encouraging short-term and mid-term outcomes.
Background: We aimed to evaluate the immediate and mid-term outcomes of transthoracic minimally invasive closure (TMIC) of ruptured sinus of Valsalva aneurysm (RSVA), which is a rare and mostly congenital heart disease. Methods: From January 2014 to November 2020, 19 patients (16 males, 3 females) with RSVA were selected for TMIC and were followed up at our centre. Data were analysed from our prospectively collected database and clinical mid-term follow-up was obtained. Results: Among these 19 cases, transthoracic echocardiography showed rupture of the right coronary sinus to the right atrium in 9 patients, non-coronary sinus rupture to the right atrium in 7 patients, and right coronary sinus rupture to the right ventricle in 3 patients. Most (13/19) cases were New York Heart Association (NYHA) functional class III or IV. The mean diameters of the defect from the aortic end and ruptured site were 8.8 +/- 3.0 and 6.4 +/- 2.6 mm, respectively. TMIC was attempted using ventricular septal defect (VSD)/patent ductus arteriosus (PDA) occluders 2-7 mm larger than the aortic ends of the defects. All patients were successfully treated by TMIC and achieved complete closure at discharge after a mean hospital stay length of 6.2 +/- 2.5 days. Seventeen patients were NYHA class I while 2 patients were NYHA class II. No cases of residual shunts, device embolization, infective endocarditis, or aortic regurgitation were observed during a median follow-up of 36 months (range, 16-84 months). Conclusions: In appropriately selected cases with RSVA, TMIC is an attractive alternative to surgery, with a high technical success rate and encouraging short-term and mid-term outcomes. However, long-term follow-up is needed.
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