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Volume 6 Number 1, January - April, 1991

ORIGINAL ARTICLE

DOI: http://dx.doi.org/10.1590/S0102-76381991000100008

Aneurysm of the sinus of Valsalva: analysis of seven cases

Aneurisma do seio de Valsalva: análise de sete casos

Ricardo M Mustafá; Domingo M Braile; Roberto V Ardito; José Luiz Verde dos Santos; Marcos Zaiantchik; Marcelo José Ferreira Soares; João Carlos Ferreira Leal

Correspondence To:
Ricardo M. Mustafá
Rua Castelo D'Água, 3030
15015 São José do Rio Preto, SP, Brasil

ABSTRACT
The authors present their experience on seven cases of Valsalva-sinus aneurysm (VSA) at the Instituto de Moléstias Cardiovasculares (IMC), from January 1984 to July 1990, treated surgically using bovine pericardium patch (PB-IMC) or valve replacement when indicated. Five cases were congenital and two were related to rheumatic disease. In two of the congenital cases the aneurysms were leaking into the right atrium, two were leaking into the right ventricle. And the remaining one was not leaking but was projected into the left ventricle. One of the congenital cases was leaking into the right ventricle and the other presented protrusion of the aneurysmatic sac into the left ventricle and eversion of the corresponding aortic leaflets. A bovine pericardium patch was used to give support for he sutures inxthe congenital ASV cases; for the cases related to rheumatic disease a valve replacement was performed using an IMC-PB biologic valve. From the congenital VSA patients, one had deiscence of suture at seven months and at six years, and was submitted to reoperation in both occasions. In the related to rheumatic disease group one died due to stroke on the 15 th postoperative day. The use of PB patch proved satisfactory in this treatment, providing good support for the suture.

Keywords aneurysms of the sinus of Valsalva, surgery.


RESUMO
Os autores apresentam a experiência acumulada de janeiro de 1984 a julho de 1990, no Instituto de Moléstias Cardiovasculares (IMC), de sete casos de aneurisma do seio de Valsalva (ASV), tratados cirurgicamente com uso de retalho de pericárdio bovino (PB), ou troca valvar nos casos indicados. Cinco casos eram de origem congênita e dois estavam associados a doença reumática. Dos congênitos, quatro estavam rotos, sendo dois para o átrio direito e dois para o ventrículo direito; em um caso não havia rotura e se projetava para o ventrículo esquerdo. Dos dois casos associados a doença reumática, um estava roto para o ventrículo direito e o outro apresentava protrusão do saco aneurismático para o ventrículo esquerdo e eversão da válvula aórtica correspondente. Foi usado retalho de PB para dar sustentação à sutura nos casos de ASV congênitos; destes, um evoluiu com deiscência da sutura aos sete meses e aos seis anos, sendo reoperado nas duas ocasiões. Nos casos associados a doença reumática, foi realizada a substituição valvar com prótese biológica PB IMC; dos dois pacientes, um foi a óbito, em decorrência de acidente vascular cerebral, no 15º dia de pós-operatório. Conclui-se que, quando não há alterações secundárias nas válvulas (ex.: calcificação, endocardite, etc), a restauração é possível e desejada, com boa evolução quando se usa retralho de pericárdio bovino.

Palavras-Chave aneurismas do seio de Valsalva, cirurgia.

Full text available only in portuguese PDF format.

REFERENCES

1. BUCHBINDER, N. A. & ROBERTS, W. C. - Left-sided valvular active infective endocarditis: a study of forty-five necropsy patients. Am. J. Med., 53: 20-35, 1972. [MedLine]

2. BURAKOVSKY, V. I.; PODSOLKOV, U. P.; SABIROW, B. N.; NASEDKINA, M. A.; ALEKIAN, B. G.; DVINYANINOVA, N. B. - Ruptured congenital aneurysm of the sinus of Valsalva. J. Thorac. Cardiovasc. Surg., 95: 836-841, 1988. [MedLine]

3. De BAKEY, M. E.; DIETRRICH, E. B.; LIDDICOAT, J. E.; KINARD, S. A.; GORRETT, H. E. - Abnormalities of the sinuses of Valsalva experience with 35 patients. J. Thorac. Cardiovasc. Surg., 54: 312-332, 1967. [MedLine]

4. DURAS, P. F. - Heart block with aneurysm of the aortic sinus. Br. Heart J., 6: 61-65, 1944. [MedLine]

5. EDWARDS, J. E.; BURCHELL, H. B.; CHRISTENSEN, N. A. - Specimen exhibiting the essencial lesion in aneurysm of the aortic sinus. Proc. Staff Meet. Mayo Clin., 31: 407-412, 1956. [MedLine]

6. ELIOT, R. S.; WOLBRINK, A.; EDWARDS, J. E. - Congenital aneurysm of the left aortic sinus: a rare lesion and a rare cause of coronary insufficiency. Circulation, 28: 951-956, 1963. [MedLine]

7. FALHOLT, W. & THOMSEN, G. - Congenital aneurysm of the right sinus of Valsalva, diagnosed by aortography. Circulation, 8: 549-553, 1953. [MedLine]

8. FISHBEIN, M. C.; OBMA, R.; ROBERTS, W. C. - Unruptured sinus of Valsalva aneurysm. Am. J. Cardiol., 35: 918-922, 1975. [MedLine]

9. JONES, A. M. & LANGLEY, F. A. - Aortic sinus aneurysms. Br. Heart J, 11: 325-341, 1949. [MedLine]

10. KAKOS, G. S.; KILMAN, J. W.; WILLIAMS, T. E.; HOSIER, D. M. - Diagnosis and management of sinus of Valsalva aneurysm in children. Ann. Thorac. Surg., 17: 474-478, 1974. [MedLine]

11. KERBER, R. E.; RIDGES, J. D.; KRISS, J. P.; SILVERMAN, J. F.; ANDERSON, E. T.; HARRISON, D. C. - Unruptured aneurysm of the sinus of Valsalva producing right ventricular outflow obstruction. Am J. Med., 53: 775-783, 1972. [MedLine]

12. KWITTKEN, J.; CHRISTOPOULOS, P.; DUA, N. K.; BRUNO, M.S. - Congenital and acquired aortic sinus aneurysm: a case report of each with histologic study. Arch. Intern. Med., 115: 648-691, 1965.

13. MEYER, J.; WUKASCH, D. C.; HALLMAN, G. L.; COOLEY, D. A. - Aneurysm and fistula of the sinus of Valsalva clinical considerations and surgical treatment in 45 patients. Ann. Thorac. Surg., 19: 170-179, 1975. [MedLine]

14. NOWICKI, E. R.; ABERDEEN, E.; FRIEDMAN, S.; RASHKING, W. J. - Congenital left aortic sinus: left ventricle fistula and review of aortocardiac fistulas. Ann. Thorac. Surg., 23: 378-388, 1977. [MedLine]

15. SAKAKIBARA, S.; KONNO, S. - Congenital aneurysm of the sinus of Valsalva associated with ventricular septal defect. Am Heart J., 75: 595-603, 1968. [MedLine]

16. SAWYERS, J. L.; ADAMS, J. E.; SCOTT, W. - Surgical treatment for aneurysm of the aortic sinuses with aorticoatrial fistula. Surgery, 41: 26-42, 1957. [MedLine]

17. SHUMACKER, H. B. - Aneurysms of the aortic sinuses of Valsalva due to bacterial endocarditis, with special reference to their operative management. J. Thorac. Cardiovasc. Surg., 63: 896-902, 1972. [MedLine]

18. SHUMACKER, H. B. & JUDSON, W. F. - Rupture of aneurysm of sinus of Valsalva into left ventricle and its operative repair. J. Thorac. Cardiovasc. Surg., 45: 650-656, 1963. [MedLine]

19. SPENCER, F. C.; BLAKE, H. A.; BAHNSON, H. T. - Surgical repair ruptured aneurysm of sinus of Valsalva in two patients. Ann. Surg., 152: 963-968, 1960. [MedLine]

Article received on february 15, 1991.

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