Raphal Cord Rupture: A Rare Mechanism of Aortic Regurgitation in Bicuspid Aortic Valve

Geoffrey D Huntley; Jared G Bird; Ying-Chun Lo; Gabor Bagameri; Hector I Michelena

doi:10.1016/j.jaccas.2023.101791

Raphal Cord Rupture: A Rare Mechanism of Aortic Regurgitation in Bicuspid Aortic Valve

JACC Case Rep. 2023 Feb 24:11:101791. doi: 10.1016/j.jaccas.2023.101791. eCollection 2023 Apr 5.

Authors

Geoffrey D Huntley¹, Jared G Bird¹, Ying-Chun Lo², Gabor Bagameri³, Hector I Michelena¹

Affiliations

¹ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
² Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
³ Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

A 70-year-old male with chronic aortic regurgitation was referred with abrupt worsening heart failure. Late referral markers were pulmonary hypertension, mitral regurgitation, and tricuspid regurgitation. Evaluation revealed rupture of a raphal cord or fenestrated raphe from the conjoined cusp of a congenitally bicuspid aortic valve, a rare mechanism of aortic regurgitation. (Level of Difficulty: Intermediate.).

Keywords: aortic regurgitation; bicuspid aortic valve; fenestrated raphe; raphal cord.

Publication types

Case Reports