Archives of the Turkish Society of Cardiology
Unicuspid aortic valve with false aortic dissection appearance: A case report [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(3): 242-244 | DOI: 10.5543/tkda.2021.27793

Unicuspid aortic valve with false aortic dissection appearance: A case report

Barkın Kültürsay, Berhan Keskin, Seda Tanyeri, Ali Karagöz, Cihangir Kaymaz
Department of Cardiology, Koşuyolu High Specialization Training and Research Hospital, İstanbul, Turkey

Summary– Unicuspid aortic valve (UAV) is a rare congenital anomaly that usually presents with aortic stenosis or mixed stenosis and regurgitation early in life. Ascending aortic aneurysm and aortic dissection are important complications of UAVs. A 27-year-old man presented to the emergency department with a complaint of acute chest pain. Bedside transthoracic echocardiography (TTE) showed dilatation of ascending aorta (47 mm) and mild aortic regurgitation; computed tomography (CT) angiography revealed a suspicious dissection flap within ascending aorta. A cardiovascular surgeon, a radiologist, and a cardiologist were immediately consulted. TTE performed by the cardiologist revealed a unicuspid unicommissural aortic valve and dilated ascending aorta with no signs of dissection. Aortic dissection image on CT angiogram was interpreted by an experienced radiologist and the cardiovascular surgeon as superior pericardial recess and considered as a false-positive dissection image. Given the patient was pain-free, the CT image was considered false positive and as TTE clearly visualized the ascending aorta, the heart team decided that no further imaging is required. After excluding acute aortic syndrome, acute coronary syndrome, and other causes of acute chest pain, the patient was discharged with close follow-up. Diagnosis of aortic dissection is based on noninvasive imaging modalities, and CT is the first-line imaging choice in most emergency departments. Depending on a single imaging modality may cause false interpretations and lead to unnecessary surgical explorations.

Keywords: unicuspid, aortic dissection, aortic valve, aortic aneurysm, echocardiography



How to cite this article
Barkın Kültürsay, Berhan Keskin, Seda Tanyeri, Ali Karagöz, Cihangir Kaymaz. Unicuspid aortic valve with false aortic dissection appearance: A case report. Turk Kardiyol Dern Ars. 2021; 49(3): 242-244

Corresponding Author: Barkın Kültürsay, Türkiye
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