Surgical Repair of a Ruptured Sinus of Valsalva Aneurysm Complicated by Ventricular Septal Defect and Aortic Valve Insufficiency

Abstract

A 23-year-old male patient was admitted with a 2-week history of congestive heart failure. An echocardiogram revealed an aneurysm originating from the right sinus of Valsalva with a small perforated area on the edge, a ventricular septal defect and severe aortic valve insufficiency. A decision for surgery was made. The right sinus of Valsalva was repaired from the inside. The infundibulotomy was closed using a continuous suturing technique and pericardial patch was used incorporating the ventricular septal defect and the previously repaired right sinus of Valsalva. The aortic valve was replaced with a mechanical prosthesis. Follow-up was unproblematic, and he was discharged on the 12th postoperative day. Aortic valve insufficiency and a high output shunt cause an increase in the ventricular diameter, impairment of the ejection fraction, congestive heart failure and resultant pulmonary pathology. Ventricular enlargement or impaired ejection fraction does not necessarily deem these patients inoperable.