Traumatic rupture of the aortic valve and ascending aorta diagnosed by transesophageal echocardiography

The most common site for rupture of the aorta as a consequence of blunt chest trauma is at the level of the isthmus. Rupture of the aortic valve with concomitant rupture of the ascending aorta is an uncommon entity and only relatively few patients sustaining such an injury survive to surgery. Early diagnosis of such injuries are critical to facilitate timely intervention. We report a case of a 17-year old male who sustained a rupture left coronary cusp and ascending aorta in a road traffic accident. The diagnosis was preoperatively made by transesophageal echocardiography and he underwent successful surgical repair with primary apposition of the torn cusp and closure of the aorta with a pericardial patch. Preoperative diagnosis of this rare combination of injury has hitherto not been made by transesophageal echocardiography.