Transcatheter Closure of Ruptured Sinus Valsalva Aneurysms With Amplatzer Occluder

We report the transcatheter closure of 6 ruptured sinus of Valsalva aneurysms (RSVAs) in 5 patients aged 18-51 years. The RSVA extended into the right atrium in 3 patients, into the right ventricular outflow tract in one, and into the pulmonary artery in one. In all patients, the RSVA was entered from the aorta, an arteriovenous loop was created, and the Amplatzer occluders were implanted using a venous approach. Six procedures were performed in 5 patients. Five Amplatzer duct occluders and 1 Amplatzer atrial septal occluder were implanted. In 1 patient who had a left RSVA after deployment of an Amplatzer duct occluder, ST-segment depression was observed on the ECG and the procedure was abandoned. In the other 4 patients, complete closure of the RSVA was confirmed by color Doppler echocardiography. No complications were observed during 9-19 months of follow-up. Percutaneous closure of an RSVA is feasible and can be used as an alternative to surgery.

Presentamos el cierre transcatéter de 6 aneurismas del seno de Valsalva con rotura (ASVR) en 5 pacientes de 18-51 años. El ASVR estaba abierto a la aurícula derecha en 3 pacientes, al tracto de salida ventricular derecho en uno y a la arteria pulmonar en otro. En todos los pacientes, se atravesó el ASVR desde el lado aórtico, se creó un bucle arteriovenoso y se implantaron oclusores Amplatzer con un abordaje venoso. Se realizaron 6 intervenciones en 5 pacientes. Se implantaron 5 dispositivos Amplatzer Duct Occluders (ADO) y un Amplatzer Atrial Septal Occluder (ASO). En 1 paciente con un ASVR izquierdo tras el despliegue de un ADO, apareció una depresión del ST en el ECG y se abandonó la operación. El cierre completo del ASVR se confirmó mediante Doppler color en los otros 4 pacientes. No se observaron complicaciones durante el seguimiento de 9-19 meses. El cierre percutáneo del ASVR es una intervención factible que puede sustituir al tratamiento quirúrgico.