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Sinus of Valsalva Aneurysm Treatment & Management

  • Author: Anuradha Tunuguntla, MD, FACC; Chief Editor: Park W Willis IV, MD  more...
Updated: Jul 15, 2014

Medical Care

Medical management usually involves stabilization (eg, optimizing medications for heart failure syndrome) and perioperative assessment and management.[8]

Transcatheter closure of ruptured sinus of Valsalva aneurysm (SVA) has been successfully performed using Amplatzer devices.[14, 15, 16] Ruptured SVA have been treated with transcatheter closure to avoid sternotomy and cardiopulmonary bypass in critically ill patients.

Although advanced percutaneous techniques have been performed in the correction of this anomaly, open-heart surgery with or without aortic valve replacement remains the treatment of choice.


Surgical Care

Cardiothoracic surgery consultation is urgent in patients with ruptured SVA, because clinical deterioration can be rapid.

Conventionally, with an operative mortality rate of less than 2%, surgical repair of the ruptured SVA has been the mainstay of therapy. Urgent surgical repair is recommended in all patients with ruptured SVA, especially with intracardiac shunting.[17, 18, 19] Aggressive surgical correction of unruptured SVA is often recommended because of its association with increased morbidity and mortality.[7, 20, 21, 22, 23, 24]

  • Aortic root reconstruction or replacement
  • Aortic valve repair or replacement
  • Bentall procedure (valved conduit)
  • Ventricular septal defect repair (if present)
  • Atrial septal defect repair (if present)
  • Primary suture closures (pledget) and patch closures (if ruptured)
Contributor Information and Disclosures

Anuradha Tunuguntla, MD, FACC Interventional Cardiologist, Director of Cardiac Catheterization Lab, Veterans Affairs Medical Center of Wilkes Barre, PA

Anuradha Tunuguntla, MD, FACC is a member of the following medical societies: American College of Cardiology, Society for Cardiovascular Angiography and Interventions

Disclosure: Nothing to disclose.


Elyse Foster, MD Director of Non-Invasive Cardiology, Department of Medicine, Division of Cardiology, Professor of Medicine, University of California, San Francisco, School of Medicine

Elyse Foster, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Society of Echocardiography

Disclosure: Received grant/research funds from Abbott Vascular Structural Heart for research.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven J Compton, MD, FACC, FACP, FHRS Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals

Steven J Compton, MD, FACC, FACP, FHRS is a member of the following medical societies: American College of Physicians, American Heart Association, American Medical Association, Heart Rhythm Society, Alaska State Medical Association, American College of Cardiology

Disclosure: Nothing to disclose.

Chief Editor

Park W Willis IV, MD Sarah Graham Distinguished Professor of Medicine and Pediatrics, University of North Carolina at Chapel Hill School of Medicine

Park W Willis IV, MD is a member of the following medical societies: American Society of Echocardiography

Disclosure: Nothing to disclose.


William J Stewart, MD Professor, Department of Cardiovascular Disease, The Cleveland Clinic Lerner College of Medicine

William J Stewart, MD, is a member of the following medical societies: American College of Cardiology and American Society of Echocardiography

Disclosure: Nothing to disclose.

Wai Hong Wilson Tang, MD Associate Professor of Medicine, Section of Heart Failure and Cardiac Transplantation Medicine, Cleveland Clinic Foundation

Wai Hong Wilson Tang, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, American Society for Clinical Investigation, Heart Failure Society of America, and International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.

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