Background: In this article, we reviewed our five-year experience in the repair of ruptured sinus of Valsalva aneurysm (RSVA), and the current literature regarding the efficacy of patch closure.

Methods: A retrospective review identified 19 patients (15 males, 4 females; mean age 28±12 years; range 14 to 55 years) who underwent RSVA repair between January 2009 and October 2013. The RSVA originated from the right coronary sinus in 17 patients (89.4%), and from the noncoronary sinus in two patients (10.5%). Ruptured sinus of Valsalva aneurysm did not originate from the left coronary sinus in any of the patients. In 11 patients (57.8%), the most common occurrence was right ventricular rupture, whereas it was right atrial rupture in eight patients (42.10%). Common associated defects were subaortic ventricular septal defect in two patients (10.7%), aortic insufficiency in seven patients (36.8%), and tricuspid insufficiency in one patient (5.2%). A bicameral approach was used for repair. Ruptured sinus of Valsalva aneurysm was repaired with an expanded polytetrafluoroethylene patch in all cases. Aortic valve was replaced in seven patients, and tricuspid in one patient.

Results: The hospital mortality rate was 5.2%. Follow-up, ranging from one month to 4.5 years, was available in 94.3% of survivors (n=18). Actual survival rate was 95%. Freedom from reoperation was 100%.

Conclusion: To conclude, surgical repair appears to be the optimal choice for the treatment of RSVA. Rapid surgical intervention after diagnosis may lead to successful outcomes.

Keywords : Acyanotic congenital heart disease; patch repair; ruptured aneurysm; sinus of Valsalva aneurysm