Echocardiographic manifestations of flail aortic valve leaflets.

Six patients with aortic regurgitation secondary to flail aortic valve leaflet syndrome were studied echocardiographically, angiographically, surgically, and pathologically. The etiology of flail aortic leaflet was myxomatous degeneration in four patients and bacterial endocarditis in two. The echocardiographic manifestations of flail aortic valve leaflet are diastolic fluttering of the aortic cusp echoes, abnormal systolic aortic leaflet movement, and abnormal diastolic fluttering echoes in the left ventricular outflow tract. Diastolic fluttering of the aortic valve leaflets is specific echocardiographic evidence of aortic regurgitation due to flail aortic leaflets, and demonstration of diastolic fluttering of the aortic leaflets and diastolic fluttering echoes in the left ventricular outflow tracts is direct evidence of flail and prolapsed aortic leaflets.