1056 AN OUT OF ORDINARY CASE OF ACUTE SEVERE AORTIC REGURGITATION IN SPONTANEOUS AORTIC VALVE LACERATION


 A 77-year-old male presenting with acute chest pain and syncope was sent to our emergency room by ambulance. An echocardiogram revealed severe pericardial effusion, thoracic aortic ectasia, and mild aortic regurgitation (AR). Computed tomography (CT) scan did not demonstrate aortic dissection. He underwent emergency pericardiocentesis for acute cardiac tamponade. After three hours of clinical monitoring, the transthoracic echocardiogram revealed de-novo severe AR, and CT scan showed a probable laceration of left ventricular wall at the level of left sinus of Valsalva. The lesion was confirmed during urgent cardiac surgery and it was successfully repaired using stitches intertwined with double pledglet and aortic bioprosthesis implant.