ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Dilated sinuses of Valsalva subsequent to type A dissection surgery: Is reoperation inevitable?
Yiğit Köse1, Selen Özyurt Köse2, Cevdet Uğur Koçoğulları1
1Department of Cardiovascular Surgery, Health Sciences University, Dr. Siyami Ersek Chest Heart and Vascular Surgery Training and Research Hospital, Istanbul, Türkiye
2Department of Neurology, Marmara University Pendik Training and Research Hospital, Istanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2023.24330
Background: This study aims to investigate the dilation of sinus valsalva in patients who underwent aortic repair due to type A aortic dissection and to evaluate its progression.

Methods: Between January 2004 and December 2019, a total of 68 patients (50 males, 18 females; mean age: 54.2±10.1 years; range, 30 to 82 years) who underwent root-preserving surgery and followed for at least one year in the outpatient setting were retrospectively analyzed. The patients were divided into two groups according to dilatation during follow-up. Group 1 (n=32) included patients with dilatation and Group 2 (n=36) included patients without dilatation. The sinus of Valsalva diameters were measured using pre- and postoperative computed tomography angiography.

Results: The mean follow-up was 4.9±3.1 (range, 1 to 4) years. Sinus of Valsalva dilatation was observed in 47% of the patients during follow-up. Preoperative sinus of Valsalva diameter was a risk factor for aneurysmatic dilatation. A diameter of ≥4.05 cm was calculated as a cut-off value for developing dilatation requiring reoperation.

Conclusion: Follow-up using postoperative echocardiography or computed tomography angiography is of utmost importance for the assessment of development of sinus of Valsalva dilatation which requires reoperation in patients without intervention to the aortic root.

Keywords : Acute type A aortic dissection, reoperation, sinotubular junction, sinus of Valsalva aneurysm
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