Multimodality Imaging of Aortic Valve Tendon Mimicking Aortic Dissection.

A 53-year-old woman was evaluated for left ventricular hypertrophy. Transthoracic echocardiography showed a mobile linear density in the ascending aorta and eccentric aortic insufficiency, raising the concern of aortic dissection. Transesophageal echocardiography and cardiac computed tomography (CT) found complex bands of tissue extending from the commissure to the aortic wall, confirming aortic valve tendon. It is an extremely rare malformation of aortic valve associated with aortic regurgitation that mimics aortic dissection. Although preoperative diagnosis has been challenging, three-dimensional echocardiography and CT reformatting aided the visualization of the spatially complex structure.