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Isolated commissural detachment of the aortic valve after minor trauma
  1. M-J Wang,
  2. J-Y Chen,
  3. T-Y Lin
  1. canonha.mc.ntu.edu.tw

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A 38 year old male patient with a history of hypertension was sent to the emergency room for shortness of breath for two days. His history revealed only minor chest trauma two weeks previously. The diagnostic workup suggested severe aortic regurgitation caused by infective endocarditis.

Intraoperative transoesophageal echocardiography showed that the commissure between the right coronary and non-coronary cusp of the aortic valve was detached from the aortic wall, with resultant right coronary cusp prolapse and severe aortic regurgitation. Successful repair of the detached commissure of the aortic valve was done under hypothermic cardiopulmonary bypass. The patient was discharged uneventfully seven days after the operation.


Embedded Image

Multiplane transoesophageal echocardiography of the aortic valve, short axis. The commissure (arrow) between the right and non-coronary cusp was detached from the aortic wall. LA, left atrium; RA, right atrium; RVOT, right ventricular outflow tract.


Embedded Image

Multiplane transoesophageal echocardiography of the aortic valve, long axis. The right coronary cusp of the aortic valve was prolapsed into the left ventricular outflow tract (arrow), which led to severe regurgitation. The aortic root was intact without dissection. LA, left atrium; Ao, Aorta.

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