Production of Aortic Regurgitation by Unperforated Aneurysm of the Sinus of Valsalva

Abstract

Unperforated congenital aneurysm of the sinus of Valsalva as a cause of aortic regurgitation and heart failure is presented with autopsy findings in a 76-year-old male. The mechanism of the aortic regurgitation based on anatomical findings is considered to be secondary to failure of fusion of the aorta to the annulus resulting in lack of normal suspending action of the elastic aorta on the annulus. The high intra-aortic pressure results in protrusion of the weakened wall into adjacent structures. Since the annulus is unsupported buckling of the rim occurs leading to interference with apposition of the valves and aortic regurgitation. When the etiology of aortic regurgitation is in doubt, unperforated aneurysm of the sinus of Valsalva should be considered.