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Aortic valve chordae tendineae: A rare cause of aortic stenosis

Cara E Saxon1, Tessa S S Genders2, Robert A Quaife2,3

  • 1Department of Medicine, University of Colorado Anschutz Medical Campus, Academic Office One, 12361 E. 17th Ave, B177, Aurora, CO 80045, USA.

Radiology Case Reports
|October 31, 2022
PubMed

Insights

A rare case of severe aortic stenosis caused by a calcified aortic valve chordae tendineae is presented. Advanced cardiac CT imaging revealed the cause, highlighting its diagnostic utility for this uncommon condition.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Aortic stenosis (AS) is a common valvular heart disease, typically caused by degenerative calcification of the aortic valve leaflets.
  • Low-flow, low-gradient AS presents diagnostic challenges, often requiring advanced imaging for accurate assessment.

Observation:

  • This report details a rare instance of severe low-flow, low-gradient AS attributed to a calcified aortic valve chordae tendineae.
  • Cardiac computed tomography (CT) with 3D reconstruction visualized a fibrous strand tethering the non-coronary cusp.

Findings:

  • The tethered non-coronary cusp was rendered functionally immobile, leading to severe aortic stenosis.
  • This case demonstrates a unique etiology for AS originating from the valve's supporting structures.

Implications:

  • This case underscores the importance of considering atypical causes of aortic stenosis.
  • Advanced cardiac CT imaging and 3D reconstruction are valuable tools for diagnosing complex valvular heart disease.
  • Understanding rare etiologies improves diagnostic accuracy and patient management in valvular heart disease.

Keywords:
Aortic stenosisAortic valveCABG, coronary artery bypass graftChordae tendineaeFibrous strandLVEF, left ventricular ejection fractionLVOT, left ventricular outflow tractTEE, transesophageal echocardiogramTTE, transthoracic echocardiogram

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