OUTCOME OF DEVICE CLOSURE OF RUPTURED SINUS OF VALSALVA (RSOV); AN EXPERIENCE AT TERTIARY CARE HOSPITAL

Abstract

ABSTRACT
BACKGROUND: Isolated rupture of the sinus of valsalva is a rare condition. Traditionally isolated rupture of the sinus has been treated surgically. Device closure by duct occluder has been described by many case series and can be used as a therapeutic option.
OBJECTIVES: To study the efficacy of different types of occluding devices for treatment of isolated rupture of the sinus of valsalva.
STUDY DESIGN: This is a retrospective, observational study, case series.
MATERIAL AND METHODS: Eight patients with isolated rupture of the sinus of valsalva underwent device closure under general anesthesia. Five were closed with classic duct occluder, 2 with reverse shank occluder and 1 with muscular occluder.
RESULTS: Eight patients with isolated rupture of the sinus of Valsalva (RSOV) underwent transcatheter device closure from 2009-2019. The mean age of presentation was 29.62 ± 7.13 years. New York Heart Association (NYHA) class at the time of presentation was II (n=6) and IV (n=2). The RSOVs were all closed using Amplatzer duct occluder I (ADO I), reverse shank duct occluder (DO-RS) and Amplatzer ventricular septal device (A-VSD). The mean procedural time was 42.3 ± 5.4 minutes, while the fluoroscopic time was 15.5 ± 5 minutes. Seven has complete successful closure, one case was unsuccessful. There was no complication. All were discharged next day. They were followed up for a mean of 6.7±4.03 years. At the time of the last follow up all the patients were in NYHA class I.
CONCLUSION: Transcatheter closure, using different occluders, of isolated RSOV is safe and can be an alternative to surgical repair and has good long term results.
KEYWORDS: Device closure, ruptured sinus of Valsalva.