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Ann Thorac Surg 1998;66:1604-1610
© 1998 The Society of Thoracic Surgeons

Repair of ruptured sinus of valsalva aneurysm: Determinants of long-term survival

Wing-Kuk Au, FRCSa, Shiu-Wah Chiu, FRCSa, Che-Keung Mok, FRCSa, Wai-Tsun Lee, FRCSa, David Cheung, FRCSa, Guo-Wei He, MD, PhDa

a Division of Cardiothoracic Surgery, Department of Surgery, University of Hong Kong, Grantham Hospital, Aberdeen, Hong Kong

Accepted for publication May 7, 1998.

Address reprint requests to Prof He, Cardiothoracic Surgery, University of Hong Kong, Grantham Hospital, 125 Wong Chuk Hang Rd, Aberdeen, Hong Kong

Background. Ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly and long-term survival after surgical treatment is not well established. This study was designed to investigate the determinants of long-term survival after repair of ruptured sinus of Valsalva aneurysm.

Methods. From April 1978 to April 1996, 53 patients underwent operation for ruptured sinus of Valsalva aneurysm. The incidence among our cardiac surgical population was 0.56%. Long-term survival was investigated in 46 patients (13 to 65 years) who survived the operation, with 96.2% follow-up completeness (mean ± standard deviation, 6.5 ± 4.9 years; maximum, 17.2 years), by univariate and multivariate analyses.

Results. There was no early operative death and no recurrence after the initial repair. Actuarial survival was 83.8% ± 8.4% at 15 years. Reoperation, aneurysm draining into the left ventricle, aortic prosthetic dehiscence, bacterial endocarditis, and aortic cross-clamp time (<70 minutes) were significant factors in long-term survival (p < 0.05). Multivariate analysis revealed that only aortic prosthesis dehiscence was the significant factor influencing late survival (p = 0.0001).

Conclusions. Surgical treatment for ruptured sinus of Valsalva aneurysm is safe and has satisfactory results. Aortic prosthesis dehiscence is the independent determinant for long-term survival. Other factors including bacterial endocarditis, concomitant ventricular septal defect repair, and aortic valve replacement did not independently influence long-term survival.




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