Aortic valvular disease with disordered blood flow may be a potential causative factor for spontaneous rupture of the ascending aorta even in the absence of aneurysm.
Aortic valvular disease may predispose to ascending aortic laceration without aneurysm; leaves open a causative role pending larger confirmatory studies.
Two autopsy cases with pericardial tamponade and spontaneous rupture of non-aneurysmal ascending aorta are described. In case 1, no apparent predisposing factor was clinically noticed in a 74 year old male patient, but postmortem examination revealed laceration of the ascending aorta associated with aortic valvular deformity and slight dilatation of the ascending aorta. In case 2, a 61 year old man, a mild to moderate grade of aortic regurgitation was noticed clinically 5 months before death. Postmortem examination revealed a slight dilatation of the aortic annulus and post-valvular portion of the ascending aorta. These two cases emphasize the clinical significance of aortic valvular disease with subsequent disordered blood flow, even when asymptomatic, as a potential causative factor for spontaneous rupture of the ascending aorta.
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Tomita et al. (1996) studied this question.
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