Transcatheter Closure of a Ruptured Sinus of Valsalva Aneurysm

• Published in: Circulation Journal Vol. 70; no. 8; pp. 1043 - 1047
• Main Authors: Chang, Chi-Wei, Chiu, Shuenn-Nan, Wu, En-Ting, Tsai, Shen-Kou, Wu, Mei-Hwan, Wang, Jou-Kou
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2006
• Subjects: Adolescent; Adult; Amplatzer duct occluder; Angiography; Aortic Rupture - diagnosis; Aortic Rupture - surgery; Aortic Rupture - therapy; Balloon Occlusion; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Cardiac Surgical Procedures - instrumentation; Cardiac Surgical Procedures - methods; Echocardiography; Echocardiography, Transesophageal; Female; Heart Septal Defects, Ventricular - pathology; Humans; Male; Middle Aged; Sinus of Valsalva - pathology; Sinus of Valsalva - surgery; Sinus of Valsalva aneurysm; Transcathter
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.70.1043

Background Ruptured sinus of Valsalva aneurysms (RSVA) can be associated with ventricular septal defects or isolated lesions. Surgical repair has been the traditional treatment of for the RSVA. The results of transcatheter closure of the RSVA in 4 patients are reported. Methods and Results From 2003 to 2004, 4 patients (2 males and 2 females) aged from 18 years to 47 years with RSVA were identified. The diagnosis of RSVA was made based on a combination of several imaging modalities. The drainage site of the RSVA was right ventricle in 2, and right atrium in remaining 2. All patients underwent general anesthesia and transesophageal echocardiographic (TEE) monitoring during the procedure. Transcatheter closure with an Amplatzer duct occluder was attempted in all 4 patients. The size of the Amplatzer duct occluder selected was up to 2 mm larger than the maximal diameter of the aortic opening site of the RSVA as measured on TEE images. The attempt to deploy an Amplatzer duct occluder was successful in 3 and a Gianturco coil was deployed in 1. Follow-up (3-18 months) echocardiography showed neither residual shunt nor aortic regurgitation in any of the patients. Conclusion The transcatheter technique is a safe alternative in the treatment of RSVA; however, a longer follow-up is mandatory. (Circ J 2006; 70: 1043 - 1047)