• Journal of Chest Surgery
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• 제12권1호
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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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• 제27권7호
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• pp.621-623
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• 1994

Over the past 3.5 years, 5 cases with ruptured sinus of Valsalva were operated upon at Asan Medical Center. Four patients were congenital and 1 traumatic. Coexistent lesions included 2 subarterial VSD, 3 AR requiring procedures [2 AVR, 1 valvoplasty], 2 subaortic membranes, 1 PDA,and 1 bicuspid AV. The communication is noncoronary sinus to RA in I and fight Coronary sinus to RV in the other 4 patients. The ~rstula was repaired through the aorta whenever possible and reinforced through the right sided chamber. There are no surgical mortality and, no recurrence of rupture yet.

• Journal of Chest Surgery
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• 제22권5호
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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.

• Journal of Chest Surgery
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• 제22권4호
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• pp.687-692
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• 1989

Aneurysm of the sinus of Valsalva is an uncommon cardiac anomaly, usually congenital in origin, which may occur as an isolated defect or in conjunction with other cardiac malformation. This report is a case of a ruptured sinus of Valsalva aneurysm with ventricular septal defect in a 18-year-old female patient who complained progressive exertional dyspnea. She underwent operative management using total cardiopulmonary bypass. The fistula originated from the right coronary sinus and ruptured into the right ventricle and coexistent lesion was supracristal ventricular septal defect. The repair was done through aortic and right ventricular approach. The ruptured sinus of Valsalva was closed with pledget suture and the ventricular septal defect was closed with patch. The postoperative result was good.

• Journal of Chest Surgery
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• 제15권1호
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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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• 제31권3호
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• pp.304-307
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• 1998

Valsalva동 동맥류는 발생빈도가 낮은 질환으로 대부분이 선천성이며 동양인에서 보다 빈번하게 발생하는 것으로 보고되고 있다. Valsalva동 동맥류는 심장내로 진행되어 우심실이나 심방으로 파열되는 경우가 대부분이고 심외성 Valsalva동 동맥류는 발생빈도가 매우 낮다. 심외성 Valsalva동 동맥류는 대부분 대동맥판폐쇄부전을 야기하고 동맥류에 의한 압박으로 우심실 유출로 협착, 심근 허혈 및 심근 경색 등을 일으킬 수 있으며 심낭내로 파열된 경우 심인성 쇼크나 돌연사를 일으키므로 매우 주의를 요하며 확진되면 외과적으로 교정하는 것이 바람직하다. 저자들은 좌관상동맥동 및 무관상동맥동에 발생한 동맥류에 의해 심근허혈 및 대동맥판폐쇄부전이 발생하였던 예를 외과적으로 치료하여 양호한 성적을 얻었기에 문헌고찰과 더불어 보고하고저 한다.

• Journal of Chest Surgery
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• 제44권3호
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• pp.240-242
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• 2011

We experienced a case of ruptured aneurysm of the sinus of Valsalva, and this resulted in simultaneous aortic and tricuspid valve endocarditis through a shunt. The echocardiography showed a ruptured sinus of Valsalva aneurysm to the right atrium with a shunt. The aortic non-coronary cusp was fibro-thickened with vegetation. Vegetations of the septal leaflet and the anterior leaflet of the tricuspid valve were also found. The blood culture grew Enterococcus garllinarum. We replaced both tricuspid and aortic valve with successful surgical result.

• Journal of Chest Surgery
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• 제18권2호
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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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• 제37권7호
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• pp.578-584
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• 2004

발살바동 동맥류는 드문 심장 기형으로 수술 후 장기 생존율이 잘 알려져 있지 않다 본 연구는 발살바동 동맥류의 수술적 치료 후 장기 성적을 알아보고자 하였다. 대상 및 방법: 1991년 1991년 3월부터 2003년 11월까지 발살바동 동맥류로 수술한 35명(남자 23, 여자 12, 평균 연령 35.2세, 범위 11세∼64세)의 환자를 대상으로 하였다. 술 전 NYHA 기능적 분류는 26명(74.3%)에서 class III∼IV였다. 술 전 심초음파상 평균 심구출률은 63.32 $\pm$ 11.43%였고 9명(25.7%)의 환자는 대동맥 판막 폐쇄 부전 grade III∼IV였다. 발살바동 파열부위의 수술은 직접 봉합이 14예(46.7%), 첩포를 이용한 폐쇄는 16예 (53.3%)에서 시행되었다. 대동맥 판막 치환술은 5예에서(14.3%) 성형술은 3예에서(8.6%) 시행되었다. 그리고 3명(8.6%)의 환자에서는 Bentall's 수술을 했으며 동반된 수술은 심실 중격 결손 폐쇄 12예 (34.3%), 심방 중격 결손 폐쇄 3예(8.6%)였다. 평균 심폐체외순환 시간은 116.79 $\pm$ 38.79분이었고 평균 대동맥 차단 시간은 81.2 $\pm$ 28.97분이었다. 결과: 수술 사망은 없었다. 1예에서 완전 방실 차단으로 영구 심장 박동기를 삽입했다. 재수술은 3예에서 시행하였는데 1예는 발살바동 동맥류 재발로 직접 봉합했고 1예는 대동맥 판막 기능 부전이 악화되어 인공 판막 치환술을, 1예는 인공 판막 치환술 후 판막 열개로 Bentall's 수술을 시행했다. 평균 추적 기간은 58.55$\pm$38.38개월이었으며 만기 사망은 1예 있었다. 5 year freedom from reoperation rate는 87.1 $\pm$ 7%였다. 결론: 발살바동 동맥류의 수술적 치료는 안전하며 만족할 만한 결과를 얻었다.

• Journal of Chest Surgery
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• 제26권6호
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• pp.488-491
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• 1993

Over the past 8 years, from 1985 to 1992, 6 patients with ruptured aneurysm of the sinus of Valsalva underwent open heart surgery in the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Five aneurysms originated from the right coronary sinus and ruptured into right ventricle and one from noncoronary sinus into RA. Ventricular septal defects were associated with 5 cases and one had no associated cardiac anomalies. The ruptured aneurysms were repaired through double incisions in 3 cases, through aortotomy in 2 cases and through right atriotomy in 1 case. There were no early and late complications and follow up results are excellent in all patients.