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Aortic Dissection with Pseudo-Aortic Regurgitation and Transient Myocardial Ischemia

A Case Report

Coronary Care Unit, Nippon Medical School, Tokyo, Japan

Keiji Tanaka, MD, PhD

Coronary Care Unit, Nippon Medical School, Tokyo, Japan

Masahiro Yasutake, MD, PhD

Coronary Care Unit, Nippon Medical School, Tokyo, Japan

Naoki Sato, MD, PhD

Coronary Care Unit, Nippon Medical School, Tokyo, Japan, nms-ns{at}nms.ac.jp

Toshimi Yajima, MD, PhD

Second Department of Surgery, Coronary Care Unit, Nippon Medical School, Tokyo, Japan

Teruo Takano, MD, PhD

First Department of Internal Medicine, Coronary Care Unit, Nippon Medical School, Tokyo, Japan

Aortic dissection causes acute aortic regurgitation in one half to two thirds of cases, which is due, mainly, to dilatation of the aortic root. The unsupported intimal flap prolapse, which crosses the aortic valve, rarely produces aortic regurgitation. Moreover, transient myocardial ischemia rarely occurs by malperfusion, which might be due to compression of the ostium of the coronary artery by the false lumen or by the intimal flap. The authors had a rare case of aortic dissection with "pseudo-"aortic regurgitation; ie, regurgitation flow existed just in the area surrounding the intimal flap during diastole and produced transient myocardial ischemia. In this case, the swinging motion of the intimal flap through the aortic valve caused pseudoaortic regurgitation and transient myocardial ischemia, which should be repaired by emergency surgical procedure. Surgery was successful and saved the patient’s life.

Angiology, Vol. 56, No. 6, 781-784 (2005)
DOI: 10.1177/000331970505600617


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