Ruptured aneurysms of sinus of Valsalva are rare cardiac anomaly. Here, we analyze retrospectively patients operated on at our hospital during the last 10 years.

Seventeen cases of ruptured congenital aneurysm of sinus of Valsalva (female:male=10:7, mean age 33.2±15.2 year) were operated during the period of January 1989 through August 1998. A ruptured aneurysm of the sinus of Valsalva was diagnosed by transthoracic 2D echocardiography and multiplane esophageal echocardiography. The diagnoses were confirmed at operation. The majority (94.1%) arose from the right coronary sinus. The right ventricle was the most common chamber of rupture (76.5%). Ventricular septal defect was associated in 13 patients (76.5%), of which 8 (61.5%) were subarterial. Ventricular septal defect was more common in aneurysms arising from the right coronary sinus (81.2%). Aortic regurgitation was found in 5 patients (29.4%). One patient underwent aortic valve repair and one an arotic valve replacement.

There was no early operative death and no recurrence after the initial repair. Postoperative morbidities were few. There was one late sudden cardiac death 3 months post-surgery. In the majority, the long-term follow-up was uneventful.

Surgery for ruptured aneurysm of sinus of Valsalva yields gratifying results, and it should be undertaken as soon as the condition is diagnosed. With recent developments, echocardiography may prove a substitute for cardiac catheterization and angiocardiography in future, and surgery could be undertaken with the help of echocardiography alone.