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J Thorac Cardiovasc Surg 2006;131:232-233
© 2006 The American Association for Thoracic Surgery

Brief Communication

A localized intimomedial defect resulted in aortic regurgitation

Naoto Morimoto, MD * , Yutaka Okita, MD, Kenji Okada, MD, Teruo Yamashita, MD, Keitaro Nakagiri, MD, Ayako Maruo, MD, Yujiro Kawanishi, MD, Masamichi Matsumori, MD, Mitsuru Asano, MD

Divisions of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University graduate school of Medicine, Kobe, Japan

Received for publication August 7, 2005; revisions received September 2, 2005; accepted for publication September 9, 2005.

* Address for reprints: Naoto Morimoto, MD, Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan (Email: naotom@juno.ocn.ne.jp).

The first 20% of the full text of this article appears below.

Acute aortic regurgitation is usually caused by aortic dissection and infective endocarditis. We describe an unusual cause of acute aortic regurgitation caused by the dislocation of the commissure, along with the localized defect of the inner side of the aorta. Histologic study disclosed that the intimal tear extended deep into all layers of the media (an "intimomedial tear") and caused acute aortic regurgitation through dislocation of the commissure.

Clinical Summary

A 41-year-old man with a diagnosis of annuloaortic ectasia and aortic insufficiency was referred to our hospital. He had acute onset of anterior neck and chest pain and was transferred to a local hospital before being transferred to ours. The results of coronary angiography were normal. An aortography showed a moderately dilated ascending aorta and grade 3/4 aortic regurgitation (Figure 1).


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  		Figure 1. Inner aspect of the aorta with a lesion characterized by a sharply delineated shallow defect (asterisk). The aortic annulus was deformed by dislocation of the commissure between the right and left coronary cusps (arrow). RCA. . . [Full Text of this Article]

 





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