Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 6 1 2014 03 04 Rheumatic Aortic Regurgitation in a Patient with Large Congenital Fenestrations in All Three Leaflets 61 63 10.5681/jcvtr.2014.012 EN Ahmadreza Jodati Babak Kazemi Naser Safaei Journal Article 10.5681/jcvtr.2014.012 2014 02 07 Fenestrations of the aortic valve rarely produce significant valvular regurgitation. These are typically described as incidental findings with little clinical significance because they generally lie above their closing edges. Rarely however, when unusually large or multiple, they can lead to massive aortic regurgitation (AR), mostly in patients with chronic hypertension and/or aortic annular dilation. We operated a 52 year old normotensive male with chronic rheumatic AR and found large fenestrations in all three aortic cusps, hardly ever reported in rheumatic valvular involvement in the literature.