Immobile right aortic leaflet in a case of the aortitis syndrome complicated by a left coronary sinus aneurysm

A 37-year-old housewife had the aortitis syndrome complicated by acute aortic regurgitation and severe coronary insufficiency. Her echocardiogram at the level of the aortic valve ring revealed an enlarged left aortic sinus and an oscillating membranous structure centrally in the lumen of the aorta. At emergency surgery, there was no intimal flap in the ascending aorta, but there was a 4 cm diameter aneurysm of the left aortic sinus. The leaflets of the aortic valve per se were normal. Following its surgical repair and an aortic valve replacement, prednisolone was administered, and all abnormal laboratory data were corrected. The oscillating structure in the ascending aorta was considered to be the right aortic leaflet whose reduced mobility was caused by a distorted aortic valve ring due to the aneurysm. An immobile aortic leaflet is an extremely rare echocardiographic finding worthy to be reported.