Aortic regurgitation secondary to back-and-forth intimal flap movement of acute type A dissection.
We present an unusual case of acute type A dissection complicated with severe aortic valve insufficiency caused by prolapse of the tubular intimal flap into the left ventricular outflow tract, which was shown legibly by transesophageal echocardiography in the diastolic phase and by intraoperative macroscopic findings. The dissected ascending aorta was excised completely and replaced without any repairing of the aortic valve, resulting in a favorable outcome for the patient. Prolapse of an intimal flap from the aorta into the left ventricle represented a rare pathophysiology of aortic regurgitation in patients with aortic dissection.
Department of Surgery, Hyogo Prefectural Kaibara Hospital, Hyogo, Japan.
Hideaki
H
Nohara
Tsutomu
T
Shida
Nobuhiko
N
Mukohara
Keitarou
K
Nakagiri
Masamichi
M
Matsumori
Kyoichi
K
Ogawa
D000208:Acute Disease; D001019:Aortic Rupture / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000503:physiopathology*; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery