• Journal of Chest Surgery
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• v.15 no.1
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• pp.124-128
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• 1982

Here, we present a case of ruptured sinus Valsalva aneurysm with fistulous communication between the right coronary aortic sinus and the right ventricle in 8 year old boy. Ruptured sinus Valsalva aneurysm is rare. And several reports are describing its pathophysiologic features, clinical findings and management. This patient was asymptomatic and the physical examination revealed palpable thrill and Grade III pansystolic murmur at the 3rd and 4th intercostal space along the left sternal border. There was an oxygen step up from right atrium into right ventricle on the cardiac catheterization reports. On 15th July 1981, an open heart surgery was performed and we found ruptured right coronary sinus Valsalva aneurysm into the right ventricle, which was managed successfully by doing direct pledget sutures. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.175-183
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• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.63-66
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• 2005

Surgical anterior ventricular endocardial restoration (SAVER) is a technique that improves hemodynamic status by excluding akinetic or dyskinetic portions of the left ventricle, restores the ventricle to normal elliptical shape and reduces ventricular wall tension to normal level in patients with acute anterior wall myocardial infarction that accompanies aneurysm. We performed redo-SAVER procedure in a 40-year old man with remodeled dilated ventricle who had already underwent LV aneurysmectomy 12 years earlier, and the results were satisfactory.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.43-49
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• 1979

This is a case report of surgically treated rupture of Valsalva Sinus aneurysm combined with VSD. He has been relatively healthy until about one month before admission, when during bath, he felt abruptly palpitation, left chest pain and exertional dyspnea. These symptoms have progressed. On admission, thrill was palpable and continuous machinery murmur was audible on 2nd and 3rd intercostal space along the left sternal border. A rupture of Valsalva`s sinus aneurysm was confirmed by aortography and echocardiography but a small VSD was found by cardiotomy in open heart surgery. On 11th Sep. 1978, open heart surgery was performed. Valsalva`s sinus aneurysm came out from right coronary aortic sinus and ruptured into the right ventricle. It sized 1.2X1.5X1.5 cm. Ruptured opening was noted on apex of aneurysm [0.8X0.8cm], VSD [1. 0X0. 3cm in size] was just below the aortic annulus. The aneurysmal sac was removed on neck. After that, VSD and aneurysmal orifice were closed together with interrupted mattress sutures on same plane. The postoperative course was uneventful and discharged three weeks after open heart surgery.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.716-719
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• 2001

The surgical treatment of postinfarct aneurysm on the posterobasal aspect of left ventricle is seldom reported compared aneurysm although the actual incidence is higher than expected, partly because of the complexity of the operation and unpredictable postoperative endoventricular circular patch plasty technique was applied successfully. The methodology is described with review of the relevant literature.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.617-620
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• 1997

Traumatic aneurysm of both the thoracic aorta and the left ventricle are extremely rare in children because it is characterized by high mortality. We report a case which we experienced recently with sucessful outcome. A Five-year-old boy had a blunt trauma by bongo bus. He had pulmonary hemorrage and pericardial effusion complicated by multiorgan failure threatening his life. Aneurysm of LV and Descending aorta were showed by 2-D echocardiogram and MRI. The atient underwent successful corrective surgery 2 and half momths after trauma, the Postoperative status of this patient was uneventful, now he is being followed up the OPD.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.665-667
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• 1999

We report a case of ruptured sinus of Valsalva aneurysm in 48-year-old male, presenting the symptom of congestive heart failure. Echocardiography showing a hairpin-like sac ex tended from the left coronary sinus to the left ventricle adjacent to the anterior mitral valve leaflet, suggested ruptured sinus of Valsalva aneurysm or aorto-left ventricular tunnel. Operative findings revealed that left sinus of Valsalva aneurysm had multiple openings faced left ventricle, 7 mm in diameter, 20 mm in length. The proximal opening was closed with bovine pericardium and distal openings were closed with spaghetti pledgeted reinforced sutures. The patient was discharged on the 14th postoperative day, and follow up for 8 months uneventfully. This case was reported for its rarity and to describe the techniques of surgical repair.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.265-272
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• 1985

Congenital aneurysm of sinus of Valsalva is one of the rare congenital heart disease, which is usually asymptomatic until rupture. The aneurysm usually ruptures into a cardiac chamber and produces an aorto-intracardiac fistula. Ruptured aneurysm is a grave lesion in that it causes heart failure and subsequent death. If, however, it is discovered in its early stages and operated on properly, it can be corrected with considerable success. Form January 1975 through December 1984, 18 consecutive patients with congenital aneurysm of sinus of Valsalva underwent corrective surgery using total cardiopulmonary bypass in our department of Thoracic Surgery. 1. The incidence was about 0.9% of surgical cases of congenital heart disease during that period. 2. 13 were males and 5 females, with ages ranging 12 years to 52 years. 3. Associated anomalies were VSD in 14, infundibular PS in 1, aberrant muscle band in RVOT in 1, and secondary aortic insufficiency in 9. 4. 17 were suggested to arise from right coronary sinus and 1 from noncoronary sinus; Among 17, 12 ruptured into right ventricle, and one from noncoronary sinus into right atrium. 5. Surgical correction was performed by means of direct suture closure with combined pledget or patch graft after aneurysm resection, and associated lesions were also corrected simultaneously. 6. There was only one case of operative mortality, and all the other patients were relatively uneventful in their follow-up studies.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.975-978
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• 2003

At least 88 percents of ventricular aneurysms result from anterior infarction, while the remainder follow inferior infarction. Posterior infarction that produce a distinct left ventricular aneurysm is unusual. We report two operative cases of postinfarction posterobasal left ventricular aneurysms, one with a true aneurysm and the other with a false one.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.748-752
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• 1989

We experienced 6 patients with the sinus Valsalva aneurysm rupture during last 12 years [Jan. 1977-Sep. 1989]. Of them. 5 cases were reviewed. They consist of 3 males and 2 females, and the age ranged from 12 years to 40 years with the mean age of 25 years. 4 patients showed congestive heart failure symptoms. The diagnosis was made by 2D-Echo and cine-angiogram. In 4 patients. sinus Valsalva aneurysm ruptured from the Rt. coronary sinus to the Rt. ventricle, and in one from non-coronary sinus to the Rt. atrium. In 2 cases, resection of the aneurysm and simple stitch closure was made. Resection of the aneurysm k patch closure and AVR in one, closure of the fistula, AVR and patch closure of the associated VSD in one, and closure of the fistula, AVR k TVR in one were made in another 3 cases. There was no postoperative mortality case.