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A 62-year-old man was found to have an asymptomatic ascending aortic aneurysm (6.6 cm) associated with severe aortic regurgitation. Operative resection of the wall of the aneurysm disclosed its cause to be multiple healed intimal-medial tears without dissection involving a previously normal aorta. The concept of an intimal-medial tear unassociated with aortic dissection is a poorly recognized entity...