The Immediate and Follow-up Results of Transcatheter Occlusion of the Ruptured Sinus of Valsalva Aneurysm With Duct Occluder

Background. Percutaneous transcatheter closure is an alternative strategy to traditional conventional surgical repair for ruptured sinus of Valsalva aneurysm (RSVA). The immediate and follow-up results of transcatheter occlusion in 13 patients were reported. Methods. From February 2004 to June 2009, a total of 13 patients (9 males, 4 females), ages 18-38 years, were involved in the report. The diagnosis of RSVA was made based on a combination of several imaging modalities. None of the patients had other associated congenital heart disease, and all underwent local anesthesia. Transthoracic echocardiography was used during the procedure. All patients received aspirin (100 mg/day) and clopidogrel (75 mg/day) for a 6-month period after the procedure. Enalapril (5-20 mg/day) was administered to the patients with heart failure and/or cardiac dilatation. Chest radiography, electrocardiogram, and transthoracic echocardiography were undertaken at intervals of 1, 6, 12, 24, 36, 48, and 60 months during the follow-up. Results. The size of the duct occluder selected was up to 1-3 mm larger than the maximal diameter of the RSVA opening site. The devices were successfully deployed without any complications. On follow-up, no severe arrhythmia occurred; there was no device embolization, residual shunt, RVOT obstruction, new aortic regurgitation, or rupture site. Compared with the preoperative results, the cardiothoracic ratio and left ventricular were significantly decreased in the patients with cardiac dilatation (0.54 +/- 0.05 vs 0.50 +/- 0.04, P<.05 and 54.11 +/- 2.32 vs 50.11 +/- 2.47 mm, P<.01, respectively). Conclusions. Transcatheter closure is a safe and effective alternative in the treatment of RSVA. The mid-term follow-up outcomes are good.