A case of nonpenetrating traumatic aortic regurgitation detected by transesophageal echocardiography.

A 67-year-old man, who had fell 5 meters, landing on his back, one month before, was referred because of heart failure due to aortic regurgitation (AR). Transesophageal echocardiogram (TEE) confirmed injuries in the aortic valve and the Valsalva sinus of the aorta before the surgery: the intimal flap in the Valsalva sinus of right coronary cusp (RCC), the prolapse of the RCC, and the dissection by longitudinal length of 3 cm in the Valsalva sinus of noncoronary cusp (NCC), ending as a blind pouch. Postoperative TEE confirmed the dissection was not repaired in the Valsalva sinus of the NCC. In this instance, TEE was extremely useful, compared with transthoracic echocardiography, computed tomography and magnetic resonance imaging, to assess the mechanism of AR following a nonpenetrating trauma, and to know to what degree the aortic valve and the Valsalva sinus of the aorta were destroyed.