Abstract
The aortic chordae tendineae strands (ACTS) is a rare complication that can induce aortic regurgitation. Reported cases of ACTS are very few, and this is the first case reported in Iran. Patients with unexplained aortic regurgitation should be carefully evaluated for ACTS, which can be easily observed by TEE; a decision regarding aortic valve surgery should be made based on the severity of AR. Herein we reported A 64-year-old male was admitted to our hospital for dyspnea on exertion. In transthoracic Echocardiography a fibrous band-like chordae in the aortic root attached to the noncoronary cusp of the aorta was seen, which caused retraction of the noncoronary cusp, mal-coaptation of the aortic valves, and severe eccentric jet posterior directed aortic regurgitation. As a result of the ACTS, the patient was diagnosed with severe aortic regurgitation (AR); due to the symptomatic severe AR, the patient underwent aortic valve surgical replacement.