![](https://d3hj8eczelsk9p.cloudfront.net/wp-content/uploads/2020/02/18144459/jet-1.jpg)
Kathryn Statham , Genevieve Carbonatto
1. Aortic root dilatation
- loss of leaflet coaptation
- hypertension
- connective tissue disorders (Marfans etc)
2. Loss of commissural support
- Aortic dissection
- VSD
- Aortic trauma
Aortic root dilatation
Aortic root dilatation can cause loss of leaflet coaptation as in the clips below
![](https://d3hj8eczelsk9p.cloudfront.net/wp-content/uploads/2020/02/18204438/dilated-root-300x279.png)
![](https://d3hj8eczelsk9p.cloudfront.net/wp-content/uploads/2020/02/18204323/aortic-root-3.jpg)
Loss of commissural support
Loss of commissural support will cause aortic regurgitation. This patient has a large ventricular septal defect .
Same patient with colour Doppler showing AR
A type A dissection in this patient with a bicuspid valve and aortic root dilatation is associated with severe aortic regurgitation due also to loss of commissural support.