Quadricuspid aortic valve

Abstract

A quadricuspid aortic valve is a rare congenital anomaly whose diagnosis is mostly incidental. The overall incidence in the population is less than 0.00033% in autopsies and less than 0.0065% in transthoracic echocardiography. Most patients present with valvular pathologies, the most prominent of this being aortic regurgitation. The following case report presents a 60-year-old female patient with severe aortic insufficiency. Her symptoms were rapidly progressing and she had a clear indication for valvular replacement. In the preoperative transthoracic and transesophageal echocardiography there is no evidence of a four aortic cusp. However, during the surgical procedure a native aortic quadricuspid valve was found. During surgery a fourth aortic cusp is identified. The native aortic valve was exchanged for a biological prosthetic valve. Postoperative ecography demostrates a prosthetic aortic valve with normal function. A quadricuspid aortic valve is a rare anatomic variation that can result in aortic insufficiency due to mechanical valvular anomalies.