ANEURYSM OF SINUS OF VALSALVA DISSECTING INTO INTERVENTRICULAR SEPTUM

Background. Dissection of interventricular septum by aneurysm of the s inus of Valsalva is extremely rare. We present our experience with the management of 10 patients with this condition. Methods. Ten patients with aneurysm of the sinus of Valsalva dissecting into the interventri cular septum were managed at All India Institute of Medical Sciences, New Delhi, between May 1987 and September 1996. Conduction abnormaliti es and aortic insufficiency dominated the clinical picture. Eight pati ents underwent surgical repair. Two patients refused operation, and on ly permanent pacemaker implantation was done for complete heart block in both these patients. Results. There was no hospital mortality. Foll ow-up ranged from 1 to 9 years. There was one late death due to carcin oma of the larynx, and 1 patient required reoperation for persistent a ortic insufficiency. All other patients who underwent operation are in New York Heart Association functional class I. Conclusions. We recomm end surgical repair of this condition to deal with aortic regurgitatio n and to avoid the potential risk of rupture, thromboembolism, and inf ective endocarditis. However, surgical repair offers no guarantee agai nst arrhythmias and conduction abnormalities. (C) 1998 by The Society of Thoracic Surgeons.