Acute aortic regurgitation due to spontaneous rupture of a fenestrated cusp: Report in a 65-year-old man and review of seven additional cases

Hagen Blaszyk, Agnieszka K. Witkiewicz, William D. Edwards

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

A 65-year-old man with chronic hypertension developed dyspnea, a cough, and a new diastolic murmur. Two-dimensional echocardiography showed severe aortic regurgitation. No valvular vegetations were identified and blood cultures were negative. Surgical intervention was recommended, but the patient died of an acute intracranial hemorrhage two weeks later. At autopsy, the posterior aortic cusp was flail, due to rupture of the residual cord above two large fenestrations. There was no acute or healed endocarditis. To our knowledge, this is the eighth reported case of aortic valve incompetence due to spontaneous rupture of a fenestrated cusp. Patients ranged in age from 31-67 years (mean, 54), and 4 (50%) were older than 60 years. Seven (88%) of the 8 were men, and 4 (57%) of 7 had chronic hypertension. Analogously, in another four reported cases, aortic insufficiency developed following spontaneous rupture of the fenestrated raphe of an atypical congenitally bicuspid aortic valve. Noninfective and nontraumatic rupture of cord-like aortic valve structures may result in severe acute aortic regurgitation, particularly in men with chronic hypertension. Copyright (C) 1999 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)213-216
Number of pages4
JournalCardiovascular Pathology
Volume8
Issue number4
DOIs
StatePublished - Jul 1 1999

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cardiology and Cardiovascular Medicine

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