Transesophageal Echocardiography of the Quadricuspid Aortic Valve

Two Consecutive Cases of Quadricuspid Aortic Valve and a Review of 149 Cases

The quadricuspid aortic valve (QAV) is a rare congenital anomaly that typically is unrelated to other cardiac anomalies. It usually is discovered incidentally through imaging modalities such as echocardiogram or computed tomography angiogram, during surgery, or autopsy. Some patients with QAV develop aortic regurgitation and, rarely, other cardiovascular complications like aortic aneurysm. Due to its rarity, it is difficult to characterize these patients or standardize management. However, review of case reports can be very useful in rare medical conditions such as QAV. In this manuscript, in addition to presenting two cases of QAV, the authors reviewed 149 cases of QAV from 2010 to 2020 from published case studies and series in order to gain a better insight into the characteristics of the patient population with QAV and its management.

Quadricuspid aortic valve diagnosed by multidetector computed tomography (MDCT)

A quadricuspid aortic valve is very rare form of congenital cardiac valvular disease with an incidence between 0.003 and 0.043% and often incidentally found during echocardiography, surgery or on post-mortem examination (Feldman BJ, Khandheria BK, Warnes CA, Seward JB, Taylor CL, Tajik AJ. Incidence, description and functional assessment of isolated quadricuspid aortic valves. Am J Cardiol 1990; 65 : 937-8). Its diagnosis is often missed, even with the transthoracic echocardiogram, as in this patient. We report a case of a quadricuspid aortic valve that was incidentally found by 256-slice electrographically-gated multidetector row CT/tomographic angiography during screening for coronary artery disease.