Cas du 27/03/2015: A Big Jet

Presentation: A patient came to the OR with this echo loop.

#1: What is the type and severity of the valve lesion in this loop?
#2: What is the etiology of the valve lesion?

Explanation: This loop shows severe aortic regurgitation.  The aortic regurgitant jet is > 65% of the LVOT diameter and has a high turbulent pattern. The etiology of the aortic regurgitant jet is an ascending aortic aneurysm.  As the STJ dilates, the AV leaflets are pulled apart and the AR jet is central in all views. The STJ is effaced so the etiology of the ascending aortic aneurysm is probably a connective tissue disorder such as Marfans or Cystic Medial Necrosis,