Case
Report
Severe Aortic Regurgitation Resulting from a Downward Displacement of Anterior Aortic Annulus and Fibrous Strands in the Bicuspid Aortic Valve

Takehito Mishima, MD, Kazuo Yamamoto, MD, Tsutomu Sugimoto, MD, Kenji Sakakibara, MD, Akifumi Uehara, MD, and Shinpei Yoshii, MD

Aortic regurgitation is occasionally caused by fibrous strands and more rarely by downward displacement of the aortic annulus. The present report describes an 18-year-old man with aortic regurgitation resulting from an anterior-posterior type of bicuspid aortic valve with fibrous strands and downward displacement of the anterior aortic annulus. A pair of fibrous strands at the anterior cusp of the bicuspid valve lifted the free margin of the cusp, and the anterior cusp originated from the intraventricular septum. We considered that the aortic regurgitation was due to poor coaptation of the cusps because of these two conditions. After resection of the cusps and the strands, the aortic valve was replaced at the intra-annular position. (Ann Thorac Cardiovasc Surg 2010; 16: 57-59)

Key words: bicuspid aortic valve, aortic regurgitation, fibrous strand, downward displacement

Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan

Received November 4, 2008; accepted for publication January 26, 2009.
Address reprint requests to Takehito Mishima, MD: Department of Cardiovascular Surgery, Tachikawa Medical Center, 3–2–11 Kanda-machi, Nagaoka, Niigata 940–8621, Japan.

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