Percutaneous device closure of ruptured sinus of valsalva aneurysm: a preliminary experience.

Objective: To evaluate the immediate and mid-term outcomes of percutaneous device closure using patent ductus arteriosus (PDA) or ventricular septal defect (VSD) occluders in patients with ruptured sinus of Valsalva aneurysm (RSVA).

Methods: Ten patients (6 males and 4 females; age range, 19-63 years) were selected for the percutaneous device closure of RSVA between January 2005 and September 2011. In 2 patients, RSVA originated from the right coronary sinus (RCS) and ruptured into the right atrium (RA); in 6, from the RCS into the right ventricle, including 2 with very small VSDs; and in 2, from non-coronary sinus into the RA.

Results: The defects were angiographically found to be 7-15 mm at their narrowest end. All the defects were successfully occluded using either a PDA occluder 2-4 mm larger than the narrowest end or a VSD occluder 3-5 mm larger than the narrowest end. No coronary arteries were checked for patency after closure. Immediately postoperative or follow-up echocardiography showed neither significant residual shunt nor severe aortic regurgitation (AR). Clinically, the patients developed no device embolism, infective endocarditis, or hemolysis. One patient was found to have newly-developed AR at the first follow-up at 1 month. The RSVA had been closed with a PDA occluder. One case suffered from periprocedural myocardial infarction without any symptoms.

Conclusions: It is feasible and effective to use percutaneous device closure of RSVA with a PDA or VSD occluder.