KẾT QUẢ PHẪU THUẬT VỠ PHÌNH XOANG VALSALVA TẠI BỆNH VIỆN BẠCH MAI

Abstract

Background: Valsalva sinus aneurysm rupture is one of the complications of Valsalva sinus aneurysm and is relatively rare. Surgical closure of Valsalva sinus aneurysm rupture has good result and also good long-term prognosis. Objectives: Evaluate the results of surgical closure of Valsalva sinus aneurysm at Bach Mai Hospital. Subjects and methods: All patients undergoing Valsalva sinus aneurysm surgery at the Cardiovascular Surgery Unit, at Bach Mai Hospital from January 2015 to December 2023. The descriptive study: case series. Results: A total of 40 patients underwent Valsalva sinus aneurysm surgery with an average age of 39.9 ± 13.4; males accounted for 47.5%. The incidence of congenital cause was 92.5%; and acquired was 7.5%. Acute onset clinical symptoms were 45%, and gradual onset was 50%. Only 5% of asymptomatic patients. Origin of sinus from right coronary sinus (90%), non-coronary sinus (10%). Rupture site: right ventricle (80%), right atrium (17.5%), left ventricle (2.5%). Concomitant ventrical septal defect accounts for 57.5% (outlet 50%, perimembrance 7.5%). Concomitant aortic valve was 50%. Direct closure technique accounts for 5%, using patch accounts for 95%. Early mortality was 0%, residual shunt 2,5%; surgical site infection 2.5%, third-degree atrioventricular block requiring permanent pacemaker 5%; mild to moderate postoperative aortic regurgitation 5%. Follow-up was on 38 patients with average of duration of 25,5 months. Long-term mortality rate 2.6%, no recurrence. Conclusion: Surgical treatment of ruptured sinus of Valsalva aneurysm is a safe and effective.