A 61-year-old man with diabetes mellitus and chronic bronchitis was brought to the hospital after falling from a roof accidentally. He received blunt trauma to the left chest wall including left rib fractures, pneumothorax, hemothorax and a fracture of left scapula. After endotracheal intubation and chest drainage, he was transferred to the intensive care unit. Sixteen days later, congestive heart failure appeared. Echocardiography showed a severe aortic valve regurgitation with a prolapse of non-coronary cusp. Eight months after the injury, his heart failure deteriorated. He underwent aortic valve replacement with a mechanical prosthesis. Upon examining the aortic valve, we noted 2 perforations in the non-coronary cusp of the aortic valve. Postoperative course was uneventful.
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