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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.


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