ROENTGENOLOGIC FINDINGS IN CONDITIONS OF THE ASCENDING AORTA SIMULATING AORTIC VALVULAR INSUFFICIENCY

¹ Associate Professor, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
² From the Departments of Radiology and Medicine, University of Minnesota, Minneapolis, Minnesota, and the Department of Pathology, The Charles T. Miller Hospital, St. Paul, Minnesota

Conditions of the ascending aorta responsible for abnormal run-off of blood when viewed roentgenographically may be divided into 2 major categories: (I) those allowing a run-off of blood through the aortic valve and (II) those characterized by an abnormal communication between the ascending aorta, on one hand, and a cardiac chamber or a mediastinal vessel, on the other. In the former situation, the roentgenograms usually indicate that the region in or around the ascending aorta is the site of disease and the decision to perform selective aortography is obvious. In the second major group, the fact that the site of the disease process begins primarily in the ascending aorta is not obvious from conventional roentgenographic data. Correlation, however, of the roentgenographic evidence for a left-to-right shunt with the auscultatory findings of a systolic and diastolic murmur indicates that selective thoracic aortography is of fundamental importance in establishing the correct diagnosis.

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