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석준호 ( Jun Ho Seok ),박종선 ( Jong Seon Park ),김영조 ( Young Jo Kim ),김기식 ( Kee Sik Kim ),허승호 ( Seung Ho Hur ),채성철 ( Shung Chul Chae ),박헌식 ( Hun Shik Park ),차광수 ( Kwang Soo Cha ),김무현 ( Mooh Hyun Kim ),김영대 ( 대한내과학회 2002 대한내과학회지 Vol.63 No.5
Background : Aneurysms of sinus Valsalva are rare anomalies thought to be primarily congenital in origin. To evaluate the clinical features and surgical results associated with ruptured aneurysm of sinus of Valsalva, we reviewed the clinical characteristics and follow up results of the patients. Methods : From January, 1991, through June 2001, 33 patients with ruptured aneurysm of sinus of Valsalva underwent surgical correction from the above five university hospitals. The patients included 24 men and 9 women, with a mean age of 32±13 years. We reviewed symptoms, physical examination findings, ECG findings, the coexistent cardiac anomalies, echocardiographic findings, surgical results in 33 patients.Results : Patterns of fistula tract were right coronary sinus-right ventricle in 24 patients (73%), noncoronary sinus- right atrium in 3 patients (9%), noncoronary sinus - right ventricle in 3 patients (9%), right coronary sinus - right atrium in 2 patients (6%) and right coronary sinus ?right ventricle and right atrium in 1 patient (3%). Combined cardiac anomalies were VSD (20 cases; 61%), ASD (1 case; 3%) and PDA (1 case; 3%). But, only 12 cases of VSD (60%) were diagnosed with preoperative transthoracic echocardiography. The aneurysmal sacs were excised in all patients and the defects were closed with a patch in 21 patients (64%) and without patch in 12 patients (36%). No recurrence was observed during follow-up periods (68±38 months) for all survivors and there was no late complications or symptoms. Conclusion : In sinus of Valsalva aneurysm patients, combined cardiac anomalies, especially VSD, are common. Careful preoperative echocardiography should be performed to detect combined anomalies. And, surgical results are excellent without recurrence.(Korean J Med 63:532-538, 2002) Key Words : Sinus of Valsalva, Aneurysm, Combined anomalies