Percutaneous closure of ruptured sinus of Valsalva aneurysms: intermediate term follow-up results.

Aims: Surgical repair used to be the conventional treatment of ruptured sinus of Valsalva aneurysms (RSOVA). Recently many articles have described the percutaneous closure of these defects. We report the successful percutaneous closure of seven cases of RSOVA.

Methods And Results: All the procedures were done under local anaesthesia with fluoroscopic and echocardiographic guidance. The defects were closed with nitinol ductal occluders introduced from the venous side after the establishment of an arteriovenous loop. Of the seven patients (four males, mean age 44.8+/-11 years), six had rupture of the congenital sinus of Valsalva aneurysm, and one had a recurrence following surgical repair. Out of the six patients with aneurysms of the right aortic sinus, four had rupture into the right atrium, one into the right ventricular (RV) inflow and the other into RV outflow. One patient had non-coronary sinus aneurysm rupturing into the right atrium. The size of the distal opening of the aneurysm varied from 2.5 to 12 mm. The left to right shunt flow ratio (Qp/Qs) ranged from 1.5 to 3.6. The size of the nitinol ductal occluders used to close the defects varied from 4 to 16 mm. After a mean follow-up period of 9.3+/-3 months, all patients remained asymptomatic with no residual flow, aortic valvar insufficiency, or evidence of infection.

Conclusions: RSOVAs can be safely and effectively closed percutaneously using nitinol ductal occluders.