Aortic fibrous strands are considered residual tissue from aortic valve development. Rupture of these strands is an important albeit uncommon cause of aortic regurgitation (AR). The authors describe a 67-year-old man who was admitted to the authors’ hospital with sudden onset shortness of breath and diagnosed with severe AR. The patient was scheduled for Bentall surgery. The transesophageal echocardiogram (TEE) found multiple fibrous strands that were present in multiple locations of the aortic valve, some of which were ruptured. Ruptured fibrous strands are in the differential diagnosis in patients presenting with acute AR without a more conventional explanation, and TEE is instrumental in securing the diagnosis.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Cardiothoracic and Vascular Anesthesia
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Bicuspid aortic valve.Ann Thorac Cardiovasc Surg. 2002; 8: 264-267
- Congenitally bicuspid aortic valves: A surgical pathology study of 542 cases (1991 through 1996) and a literature review of 2,715 additional cases.Mayo Clin Proc. 1999; 74: 14-26
- Clinical significance of the bicuspid aortic valve.Heart. 2000; 83: 81-85
- A severe restrictive aortic regurgitation resulting from valve tenting by unusual aortic chordae tendineae strands.Circulation. 2012; 126: e139-e141
- Aortic chordae tendineae strands with significant aortic regurgitation.Int Heart J. 2021; 62: 1160-1163
- Aortic regurgitation caused by rupture of the abnormal fibrous band between the aortic valve and aortic wall.Gen Thorac Cardiovas Surg. 2011; 59: 488-490
- Acute aortic regurgitation due to rupture of an anomalous cord from the raphe.Asian Cardiovasc Thorac Ann. 2017; 25: 325
- Aortic valve cord mimicking fibroelastoma.Eur J Cardiothorac Surg. 2017; 52: 1007
- Aortic valve fenestrations: A review.Porto Biomed J. 2020; 5: e083
- A fibrous band associated with the non-coronary aortic valve cusp in a dog.J Vet Cardiol. 2011; 13: 127-129
- Aortic regurgitation caused by rupture of a well-balanced fibrous strand suspending a degenerative tricuspid aortic valve.J Thorac Cardiovasc Surg. 2002; 124: 843-844
- Acute aortic regurgitation following fibrous strand rupture of aortic valve successfully diagnosed by transesophageal echocardiography.Echocardiography. 2018; 35: 753-754
- A rare cause of cardiogenic shock: A case report of aortic regurgitation due to rupture of a fibrous strand suspending a tricuspid aortic valve.CASE (Phila). 2021; 5: 335-339
- A classification system for the bicuspid aortic valve from 304 surgical specimens.J Thorac Cardiovasc Surg. 2007; 133: 1226-1233
- 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.J Thorac Cardiovasc Surg. 2021; 162: e183-e353
- The 10 commandments for aortic valve repair.Innovations (Phila). 2019; 14: 188-198
- Aortic valve repair using HAART 300 geometric annuloplasty ring: A review and echocardiographic case series.J Cardiothorac Vasc Anesth. 2022; 36: 3990-3998
- State-of-the art bicuspid aortic valve repair in 2020.Prog Cardiovasc Dis. 2020; 63: 457-464
- Special aortic chordae tendineae strand causing severe aortic regurgitation treated by transcatheter aortic valve replacement.JACC Cardiovasc Interv. 2021; 14: e267-e269
Published online: January 04, 2023
Publication stageIn Press Corrected Proof
© 2022 Published by Elsevier Inc.
ScienceDirectAccess this article on ScienceDirect
- Mystery Jets: A World of PossibilitiesJournal of Cardiothoracic and Vascular Anesthesia
- PreviewSOME 60,000 YEARS AGO, homo sapiens started migrating around the world. Their migration historically depended on climate, pressures of the population, and the invention of technologies. Today, similar factors determine the migration and movement of people across the globe, and with these movements, global physicians have a duty to learn about the diseases that are prevalent in different people from other areas of the world.