Incisura is absent in ?

The occurrence and magnitude of the incisura of the central aoic pressure were shown in 66 patients to depend on the functional state of the aoic valve. In normal subjects and children with congenital aoic stenosis (with thin flexible leaflets), the incisura ranged between 6 and 14 mm Hg. With aoic regurgitation, the incisura diminished as the severity of regurgitation increased. With calcific aoic stenosis, the incisura was smaller or absent. These observations imply a valve mechanism productive of the incisura. In vitro studies of human aoic valves confirmed these observations. Additional in vitro studies with high speed cinematography (2,000 frames/sec) of a stented normal porcine valve also showed that early diastolic stretch and recoil of the leaflets occurs. These results indicate that in the presence of a normal or diseased aoic valve the aoic incisura is produced primarily by valve distension or recoil, respectively. Distension and rebound of the aoic walls do not appear to contribute significantly in the presence of a normal or a diseased valve. Because acquired aoic valve disease affects the magnitude of the central aoic incisura, inspection of the incisura may be of ancillary valve in evaluating the pathologic state of the aoic valve. Ref Davidson 23rd edition pg 431