Das G, Lee C C, Weissler A M
Chest. 1977 Oct;72(4):464-8. doi: 10.1378/chest.72.4.464.
The diagnosis of ruptured (perforated or torn) aortic valvular leaflets due to various causes has been made primarily at surgery or postmortem examination. Although angiocardiographic studies readily reveal aortic regurgitation, they rarely establish the presence of a ruptured aortic cusp as the cause of the aortic leak. Recent echocardiographic experience has brought to our attention seven patients with ruptured aortic valvular leaflets in whom the absenc of valvular vegetations was confirmed at surgery in six and at autopsy in one. The echocardiogram of the aortic root in these subjects revealed little or no increment in the diameter of the aortic root. In systole the usual box-like configuration of the leaflets, similar to that observed in normal subjects, was seen; however, in diastole the normal thin midaortic linear echoes were replaced by a thick band of echoes which often revealed high-frequency oscillations. In addition, high-frequency fibrations of the anterior mitral leaflet in diastole and increased systolic excursion of the interventricular septum and left ventricular posterior wall were observed.
因各种原因导致的主动脉瓣叶破裂（穿孔或撕裂）的诊断主要是在手术时或尸检时做出的。尽管心血管造影研究很容易发现主动脉瓣反流，但它们很少能确定主动脉瓣叶破裂是主动脉瓣反流的原因。最近的超声心动图经验使我们注意到7例主动脉瓣叶破裂的患者，其中6例在手术中证实无瓣膜赘生物，1例在尸检时证实无瓣膜赘生物。这些患者的主动脉根部超声心动图显示主动脉根部直径几乎没有增加或没有增加。在收缩期，可见到与正常受试者相似的通常的瓣叶盒状结构；然而，在舒张期，正常的主动脉中部细线性回声被一条厚的回声带所取代，这条回声带常常显示高频振荡。此外，还观察到舒张期二尖瓣前叶的高频颤动以及室间隔和左心室后壁收缩期运动增加。
