Acute traumatic disruption of a bicuspid aortic valve

Cardiac involvement is frequent in patients with blunt chest trauma and multiple injuries. Different cardiac structures can be involved, but isolated aortic valve rupture is rare. We report the case of a man admitted to our hospital with multiple injuries as a result of a car crash. Transthoracic, followed by transesophageal echocardiography, revealed disruption of a large anterior bi-coronary cusp in a bicuspid valve with severe aortic regurgitation, without lesions or abnormalities of thoracic aorta. Aggressive pharmacological management consented to delay valve replacement to obtain resolution of concomitant pulmonary injuries.