GEOGRAPHICAL VARIATIONS IN THE PRESENTATION OF RUPTURED ANEURYSMS OF SINUSES OF VALSALVA - EVALUATION OF SURGICAL REPAIR

From 1981 to 1992, 13 male and 7 female patients underwent surgical co rrection for ruptured aneurysms of sinus of valsalva. A total surgical experience of 22 procedures including 2 reoperations is presented, ac counting for 1.37% of open heart surgery for congenital heart disease at PGIMER Chandigarh. Ninty percent were in the 20- to 40-year age gro up. Forty-five percent of patients had symptoms of > 1-year duration ( range 2 months to 20 years) and catastrophic onset of symptoms was not ed in four (18%). All patients had localized aneurysms originating eit her in right coronary sinus (14 pts) or noncoronary sinus (8 pts). Sit es of origin and rupture are detailed. Associated congenital abnormali ties such as ventricular septal defect (VSD) (13 pts), aortic regurgit ation (3 pts), and left superior vena cava and atrial septal defect (A SD) (1 pt each) were noted. The data pertaining to Oriental and Wester n groups of patients were analyzed, and the differences in age, mode o f presentation, site of origin, rupture, and the spectrum of associate d abnormalities were elucidated. The majority of the patients (86.4%) were operated by the Bicameral approach. Repair was tailored according to the extent and severity of the defect in the sinus of Valsalva and aortic valve annulus and also the presence and site of VSD.