• Hong-Wei Guo, Xiao-Gang Sun, Jian-Ping Xu, Hui Xiong, Xiao-Qi Wang, Wen-Jun Su, Ye Lin, and Sheng-Shou Hu.
• Department of Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
• Eur J Cardiothorac Surg. 2011 Nov 1;40(5):1047-51.

ObjectiveWe introduce a simple classification of the non-coronary sinus of Valsalva aneurysm, and suggest a different approach for the corresponding type of non-coronary sinus of Valsalva aneurysm.MethodsBetween October 1996 and December 2009, 45 patients with non-coronary sinus of Valsalva aneurysm underwent surgical repair. Twenty-three were male and 22 female. The mean age was 32.80±11.77 years (range, 13-67 years). We divided them into two types, type I: rupture or protrusion into right atrium; and type II: rupture or protrusion into right atrium or right ventricle near or at the tricuspid annulus. For type I (n=32), the right atrium approach was chosen, using direct suture with patch repair. For type II (n=13), the transaortic approach with right atrium incision was chosen, with patch repair through an aortic incision and direct suture through a right atrium incision. Surgical results between types I and II were compared as regards cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, and intensive care unit time, and postoperative stay time.ResultsThere was no early death after operation. There were no significant differences in cardiopulmonary bypass time, mechanical ventilation time, intensive care unit time, and postoperative stay time between two types (p>0.05). There was significant difference in clamp aorta time, with type II being longer than type I (p<0.05). Forty-three patients (93.33%) were followed up; one case of coronary artery disease using medication occurred, and there was no late death.ConclusionsApproach through the right atrium or right atrium with aortotomy showed the same early surgical results. Our classification of non-coronary SVA is simple and practical for clinical usage.Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

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