SINUS OF VALSALVA ANEURYSM - A LATE COMPLICATION AFTER REPAIR OF ASCENDING AORTIC DISSECTION

Surgical advances and the introduction of new more rapid and accurate diagnostic techniques have led to significant improvement in the survi val of patients with aortic aneurysms. However, considerable long-term morbidity and mortality remains a concern. In the present study we re port on the occurrence of sinus of Valsalva (SV) aneurysm after repair of the ascending aorta for aortic dissection as a significant long-te rm complication. Since transesophageal echocardiography (TEE) became a vailable it has been used for the follow-up of 33 hospital survivors a fter ascending aortic replacement for a mean of 27 +/- 20 months. Thos e patients who received a valved conduit were excluded from this analy sis. The aortic valve was conserved in 22 patients: 17 had a dissectin g aneurysm involving the ascending aorta and 4 patients non-dissecting aneurysms. A sinus of Valsalva diameter > 45 mm was considered an ane urysm and was found in a total of 7 patients (33 %), 5 being patients with aortic dissection. The overall reoperation rate on account of SV aneurysms was 24 %. We conclude that SV aneurysm is a significant long -term complication of patients after repair of the ascending aorta. In the light of these results we have changed our operative policy of re pair to include resorcin glue as a reinforcing agent or to perform mor e extensive repair.