Aortic regurgitation caused by cusp bending of aortic valve leaflet.

Pure aortic regurgitation (AR) is caused by primary disease of the aortic leaflet and/or the aortic root. However, there are many patients with AR with unclear etiology and mechanism. The assessment of mechanism is critical to the decision of surgical modality for AR. Echocardiography, particularly a detailed analysis of the aortic leaflets and root by transesophageal echocardiography (TEE), could be an important diagnostic step to assess its mechanism. In this report, we present a case of AR in which the TEE images led to diagnosis of cusp bending of aortic leaflet without specific findings indicating this pathology.