A Case of Surgical Repair of Ruptured Aneurysm of the Sinus of Valsalva with a Congenitally Bicuspid Aortic Valve

Kentaro Yamane Ryuichiro Shibata Yoichi Hisata

(Department of Cardiovascular Surgery, Sasebo Chuo Hospital, Sasebo, Japan)

We present a case of ruptured aneurysm of the sinus of Valsalva with congenitally bicuspid aortic valve and aortic regurgitation. A 50-year-old woman was admitted with congestive heart failure. Transesophageal echocardiography demonstrated that an aneurysm originating from the anterior sinus of Valsalva had ruptured into right ventricular outflow tract. With the aid of cardiopulmonary bypass, the aneurysm was repaired with direct closure through an aortotomy and aortic valve replacement with a Carbomedics 21mm was successfully performed. Because of the marked calcification of her cusps and shortening and thickening of the free-edge, valvuloplasty for the insufficient bicuspid valve was not applied in this case. However, valvuloplasty should be considered as the first surgical procedure of choice, even in cases of bicuspid aortic valve associated with ruptured aneurysm of the sinus of Valsalva and aortic regurgitation.
 Jpn. J. Cardiovasc. Surg. 31: 230-232 (2002)