Clinicopathologic Correlations

Abstract

Among the various anatomic classes of aortic valvular insufficiency is that associated with prolapse of one or several cusps of the valve. A number of etiologic factors come into play, including intrinsic weakness or excessive cuspid tissue, trauma, infection, inadequate support of the aorta as in certain ventricular septal defects, and loss of commissural support from laceration of the ascending aorta. The latter condition may result from trauma, cystic medial necrosis, inflammation, or hypertension. The lacerated aorta may either be associated with typical dissecting aneurysm or there may be little intramural dissection of blood. In some instances wherein prolapse of one or more cusps causes aortic insufficiency, the functional disturbance may be overcome by correcting the basic problem while preserving the natural aortic valve.