Transcatheter closure of ruptured sinus of valsalva aneurysms with an Amplatzer occluder.

We report the transcatheter closure of six ruptured sinus of Valsalva aneurysms (RSVAs) in five patients aged 18-51 years. The RSVA extended into the right atrium in three 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 five patients. Five Amplatzer duct occluders and one Amplatzer atrial septal occluder were implanted. In one 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 four 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.