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Ruptured Sinus of Valsalva Aneurysm and Gerbode Defects: Patient and Procedural Selection: the Key to Optimising Outcomes

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
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Abstract

Purpose of Review

In this review, we reflect on the historical background, clinical features and imaging techniques used to assess Gerbode defects and sinus of Valsalva aneurysms. We aim to review the evolution of treatment strategies and the progression towards less invasive management for these conditions.

Recent Findings

While transthoracic echocardiography is often diagnostic, transesophageal echocardiography (2D and 3D) has improved our understanding of these defects and allowed us to more accurately define their anatomy. Cardiac MRI provides improved assessment of the physiological impact of defects by quantifying shunt volume. Transcatheter techniques are currently vying with surgery as the mainstay of treatment.

Summary

New insights are being discovered regarding diagnostic modalities and treatment pathways. Defining criteria for patient selection for catheter or surgical therapy is essential when deciding on the optimum intervention for the individual patient.

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Abbreviations

ADO:

Amplatzer duct occluder

AR:

aortic regurgitation

ASD:

atrial septal defect

CCF:

congestive cardiac failure

LA:

left atrium

LV:

left ventricle

PC:

percutaneous closure

PAH:

pulmonary artery hypertension

RA:

right atrium

SOVA:

sinus of valsalva aneurysm

TEE:

transesophageal echocardiography

TTE:

transthoracic echocardiography

TR:

tricuspid regurgitation

VSD:

ventricular septal defect

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Our Lady’s Children’s Hospital, Dublin, Ireland

    Colm R. Breatnach & Kevin P. Walsh

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Breatnach, C.R., Walsh, K.P. Ruptured Sinus of Valsalva Aneurysm and Gerbode Defects: Patient and Procedural Selection: the Key to Optimising Outcomes. Curr Cardiol Rep 20, 90 (2018). https://doi.org/10.1007/s11886-018-1038-z

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