In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Contemporary outcomes of conservatively managed sinus of valsalva aneurysms: a 20-year Cleveland clinic experience

Session Diagnostic toolkit for a dilated aorta

Speaker Serge Harb

Event : ESC Congress 2018

  • Topic : diseases of the aorta, peripheral vascular disease, stroke
  • Sub-topic : Aortic Aneurysm, Thoracic
  • Session type : Moderated Posters

Authors : B Xu (Cleveland,US), C Rivas (Cleveland,US), J Betancor (Cleveland,US), S Harb (Cleveland,US), V Menon (Cleveland,US), B Griffin (Cleveland,US), LL Rodriguez (Cleveland,US)

Authors:
B. Xu1 , C. Rivas2 , J. Betancor1 , S. Harb1 , V. Menon1 , B. Griffin1 , L.L. Rodriguez1 , 1Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute - Cleveland - United States of America , 2Cleveland Clinic Foundation, Department of Internal Medicine - Cleveland - United States of America ,

Citation:
European Heart Journal ( 2018 ) 39 ( Supplement ), 1253

Background: Sinus of Valsalva aneurysms (SVAs) are rare. The outcomes of conservatively managed SVAs are not well known.

Purpose: We assessed the contemporary outcomes of conservatively managed SVAs.

Methods: Single-center retrospective analysis over a 20-year period (January 1997 to June 2017).

Results: 103 patients with SVAs were identified: 76 patients were surgically managed (74%); 27 patients were conservatively managed (26%). The mean patient age was: 62±20 years (vs. 54±16 years in surgical group), and the majority were male (67%). The commonest co-morbidity was hypertension (67%). Most SVAs were non-ruptured at diagnosis (93% vs. 70% in the surgical group, p<0.05). The indications for conservative management were: 1. Non-surgical size/stable on serial imaging (48%); 2. Age and co-morbidities (30%); 3. Refusal of surgery (7%). The mean duration of follow-up was 4.8 years. There were no complications or deaths directly caused by SVAs. 6 patients (22%) died from non-SVA related causes: 4 died from malignancies, 2 died from gastrointestinal bleeding.

Conclusions: In a contemporary 20-year cohort, less than one third of patients with SVAs were conservatively managed. These patients were generally older, and were more likely to present with non-ruptured SVAs. At a mean follow-up of 4.8 years, 6 deaths occurred from non-SVA related causes.

Study Cohort Characteristics
Diagnostic study (n, %)
– Transthoracic echocardiography23 (85.2)
– Transesophageal echocardiography6 (22.2)
– Computed tomography10 (37.0)
– Cardiac magnetic resonance4 (14.8)
SVA size at diagnosis (cm)3.8±1.0
– Range (cm)3.1–6.7
Location of SVA (n, %)
– Right coronary sinus16 (59.3)
– Non coronary sinus10 (37.0)
– Left coronary sinus1 (3.7)
Condition of affected sinus (n, %)
– Non-ruptured25 (92.6)
– Ruptured2 (7.4)
Follow-up (years)4.8
Characteristics of the Conservatively Managed Sinus of Valsalva Aneurysms.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are