Pathophysiology of aortic regurgitation with ventricular septal defect

Pathophysiology of aortic regurgitation. In early systole (A), ejected blood from the left ventricle (LV) will be shunted through the ventricular septal defect. As a result, the anatomically unsupported coronary cusp and aortic sinus are driven into the right ventricle (RV) (B) (Venturi effect). In diastole (C), the intra-aortic pressure forces the aortic valve leaflet to close, but the unsupported cusp (right or noncoronary) is pushed down into the left ventricular outflow tract away from the opposed coronary cusp, resulting in regurgitation.