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-Lavin, L. (1977). Thorax, 32,[619][620][621][622] Rupture of the normal aortic valve after blunt chest trauma. Rupture of the normal aortic valve after blunt trauma to the chest is seen infrequently. With the ever-increasing incidence of car Examination on admission showed an acutely ill young man with rapid respirations: blood pressure, 140/60 mmHg; pulse rate, 110/minute. Grade III/VI systolic and diastolic murmurs were again audible along the left sternal border. Breath sounds were diminished in the left lung. The chest radiograph showed interstitial densities through both lobes of the left lung and, although pulmonary contusion was suspected, early pulmonary oedema could not be ruled out (Fig. 1). An electrocardiogram showed non-specific ST-segment and T-wave changes. Cardiac cathieterisation disclosed no intracardiac shunts. Pressure The patient was operated upon with a diagnosis of severe aortic regurgitation due to non-penetrating traumatic rupture of the aortic valve leaflets. During cardiopulmonary bypass with hypothermic anoxic arrest the right coronary cusp of the aortic valve was found to be partially avulsed from the aortic annulus; the left coronary cusp was completely avulsed as was the intercoronary commissure (Fig. 2). The aortic valve was excised and a size 19 mm porcine xenograft valve' was in-

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