This case highlights a rare presentation of severe aortic regurgitation caused by a cleft-like deformity in all aortic cusps alongside a single coronary artery, likely representing an acquired modification of a congenital malformation.
A 51-year-old woman was admitted to our hospital with heart failure due to aortic regurgitation. Examination showed severe aortic regurgitation mainly due to cleft-like deformity of the right coronary cusp and single coronary artery. Aortic valve replacement was performed, and the deformity was seen in all aortic cusps. Histological study showed elongation of the leaflets by myofibrotic and fibrotic hyperplasia without calcification and inflammation in the aortic valve. This deformity likely arose from an acquired modification of a congenitally malformed aortic valve.
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Kawano et al. (2012) studied this question.
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