Aneurysm of the Sinus of Valsalva

Abstract

Materials and Methods:

8 cases were diagnosed in the cardiac cath. lab. of NICVD since February 1976.
Table I gives their age, sex and the clinical diagnosis for which they were referred for study. The average age for ruptured aneurysm is 31 years. 7 patients were males and one female.

Results:

Table II & HI show their clinical profile. The presenting complaint of our patients was dyspnea on exertion and palpitation, only one had history of paroxysmal nocturnal dyspnea. In six out of 8 cases the onset of symptoms was insidious and 4 patients were aware of buzzing sensation in the chest. Table V shows follow—up of these cases. 4 cases underwent surgery; one case has residual A.I. other 3 cases are asymptornatiC and no residual defect. One case died while waiting for surgery. 2 cases refused surgery and were still living 2 years following cardiac catheterization.

Discussion:

There are 3 sinuses at the root of the aorta just above the aortic valve; opposite the 3 aortic cusps. Two are anterior and one is posterior. They have been variously named however since 1929 this terminology has been widely adopted. The two anterior sinuses are named after their respective coronary ostia. All agree that surgery should be done as soon as ruptured sinus of  valsalva aneurysm is diagnosed because without surgery most cases would die in intractable C.H.F. In cases where there is no associated V.S.D. the onset and course is more dramatic and severe while in cases with V.S.D. the survival may be longer. Leaving a few exceptions the mean survival is 1-2 years after diagnsois. In our cases 4 had surgery with no mortality. One case has residual A.L, the others are asymptomatic. Patients requiring Aortic valve replacement and repair of aneurysm. will have higher mortality than these requiring repair alone. These patients should be observed for S.B.E. and recurrence after surgery.