{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:57:07Z","timestamp":1793213827229,"version":"4.5.0"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012542","name":"Sichuan Provincial Science and Technology Support Program","doi-asserted-by":"publisher","award":["2024YHFZ0197"],"award-info":[{"award-number":["2024YHFZ0197"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","award":["2020HXFH044"],"award-info":[{"award-number":["2020HXFH044"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Aortic chordae tendineae (ACT) are rare fibrous strands originating from early aortic valve cusp formation as embryonic remnants. Most aortic chordae tendineae are asymptomatic, but they may cause aortic regurgitation via chordal rupture or cusp restriction. This case presents transcatheter aortic valve replacement (TAVR) for aortic regurgitation secondary to aortic sinus dilation with incidentally detected ACT that did not directly contribute to valvular dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient presentation<\/jats:title>\n                    <jats:p>\n                      An 81-year-old female with hypertension presented with progressive dyspnea. Cardiac auscultation revealed a diastolic murmur over the left sternal border. Transthoracic echocardiography demonstrated severe aortic regurgitation due to significant aortic root dilatation. Transapical TAVR was\n                      <jats:sans-serif>planned<\/jats:sans-serif>\n                      . Prosthetic size was determined via computed tomography. Pre-procedure transesophageal echocardiography (TEE) identified two ACTs connecting the free margin of the non-coronary cusp to the aortic sinus wall. TAVR with a self-expanding valve was performed, with intraoperative TEE confirming stable deployment despite rupture of two ACTs. The patient recovered uneventfully without perioperative complications, and follow-up transthoracic echocardiography confirmed optimal valve position with no paravalvular leakage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      ACT presence does not preclude TAVR but requires meticulous intraoperative surveillance, TEE is critical for detecting these structures and guiding TAVR planning. Precise intraoperative positioning of valve graspers ensures avoidance of ACT-related complications, and\n                      <jats:sans-serif>rupture of ACT confirmed that<\/jats:sans-serif>\n                      it would not compromise prosthetic valve stability in the future. This case supports the feasibility of TAVR in complex aortic root anatomies with incidentally detected ACT.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1711611","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:21:28Z","timestamp":1763101288000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter aortic valve replacement for aortic regurgitation secondary to aortic sinus dilation with incidentally detected aortic chordae tendineae: case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Lingli","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e8033","DOI":"10.1002\/ccr3.8033","article-title":"The extremely rare case of aortic chordae tendineae srands: a case report with literature review","volume":"11","author":"Khansari","year":"2023","journal-title":"Clin Case Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"ehaf194","DOI":"10.1093\/eurheartj\/ehaf194","article-title":"2025 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"67","author":"Praz","year":"2025","journal-title":"Eur Heart J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ccr3.8033","article-title":"The extremely rare case of aortic chordae tendineae strands: a case report with literature review","volume":"11","author":"Khansari","year":"2023","journal-title":"Clin Case Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.3390\/diagnostics15091071","article-title":"A rare case of severe aortic regurgitation secondary to tenting of chordae tendineae strands: a multimodality imaging approach for a challenging diagnosis","volume":"15","author":"Catapano","year":"2025","journal-title":"Diagnostics"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e267","DOI":"10.1016\/j.jcin.2021.07.035","article-title":"Special aortic chordae tendineae strand causing severe aortic regurgitation treated by transcatheter aortic valve replacement","volume":"14","author":"Wei","year":"2021","journal-title":"J Am Coll Cardiol Intv"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.radcr.2022.09.099.","article-title":"Aortic valve chordae tendineae: a rare cause of aortic stenosis","volume":"18","author":"Saxon","year":"2022","journal-title":"Radiol Case Rep"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1711611\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:21:29Z","timestamp":1763101289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1711611\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":6,"alternative-id":["10.3389\/fcvm.2025.1711611"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1711611","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,14]]},"article-number":"1711611"}}