P. Simon et al., SINUS OF VALSALVA ANEURYSM - A LATE COMPLICATION AFTER REPAIR OF ASCENDING AORTIC DISSECTION, The thoracic and cardiovascular surgeon, 42(1), 1994, pp. 29-31
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.