The aortic root is widened here and the commissures of the aortic valve cusps are pulled apart. The aorta above this shows peculiar wrinkling that is typical for syphilitic aortitis. The widening of the root can cause aortic insufficiency and also aneurysmal dilation of the ascending aorta.Such dilation may also be seen with Marfan's syndrome, but the intima would not show the wrinkling.

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