Acute aortic regurgitation secondary to aortic dissection. Surgical management without valve replacement

Emergency operations were performed in 7 adult patients for severe aortic insufficiency caused by acute aortic dissection. Dissection beginning in the aortic root involved the entire thoracoabdominal aorta in at least 3 patients. The operative findings consisted of an arch of relatively normal caliber, supravalvular intimal tear, circumferential dissection, and prolapse of the aortic cusps into the left ventricle. Repair of the proximal dissected layers and elevation of the cusps to their normal position restored valve competence in every patient. Six survivors have retained normal aortic valve function four months to six years postoperatively.