Echocardiographic manifestation of flail right and noncoronary aortic valve leaflets

Echocardiographic studies provide information useful in determining the etiology and location of aortic valvular lesions, but assessment of their severity remains difficult. We report the findings in two patients with surgically confirmed right (case 1) and noncoronary (case 2) flail aortic leaflets in whom dense echoes filled the aortic root in systole, only to move from this position into the left ventricular outflow tract during diastole. This echocardiographic finding is a clinically useful noninvasive indicator of rupture of the right or noncoronary aortic cusp and dictates a need for early surgery.