Background: Ruptured aneurysms of sinus of Valsalva are defects of the
aortic media, which are uncommon yet present concomitantly with either
ventricular septal defect, aortic insufficiency or both. Here, we
analyse retrospectively outcomes of patients operated on in the last two
decades. Patients and Methods: 151 cases of ruptured aneurysms of
sinuses of Valsalva were treated here between January 2000 and December
2020. The majority (96%) arose from the right coronary sinus. The right
ventricular outflow was the most common site of rupture (56.2%).
Ventricular septal defect was associated in 24 patients (16%) all of
whom had ruptured right sinus, of which 8 (33%) were of subpulmonic
subtype. Aortic incompetence was found in 45 patients (43.3%). Elective
surgery was offered to 78 patients (51.6%), while the rest had defects
closed by interventional devices. Surgical conversion for device
embolization occurred in 12 patients (7.94 %). The defect was closed
through the aortic root in 13 patients (14.4% of 90) and employing the
bicameral technique (root and ruptured chamber) in the remaining 87
patients. 18 patients (20%) underwent aortic valve repair while 5
(5.5%) underwent aortic valve replacement. Results: We had no hospital
deaths, however 4 operated patients (2.6%) had comorbidities. Follow‐up
ranged from 1 to 20 years (mean 13 ± 5). There were 3 deaths in this
period, and among the majority, quality of life was uneventful.
Conclusion: Surgical correction for ruptured aneurysms of Valsalva
provides prudent results and must be the preferred modality of treatment
in acute and chronic presentation.