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A Journal on Surgery

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Chirurgia 2016 December;29(6):213-6


language: English

Quadricuspid aortic valve associated with severe aortic, mitral, and tricuspid regurgitations: a case report

Atsushi MORISHITA 1, Hideyuki TOMIOKA 2, Seiichiro KATAHIRA 3, Takeshi HOSHINO 4, Kazuhiko HANZAWA 5

1 Department of Cardiovascular Surgery, Numata Neurosurgery Heart-Disease Hospital, Numata, Japan; 2 Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women,s, Medical University, Tokyo, Japan; 3 Department of Surgery, Tokyo Rosai Hospital, Oota-ku, Japan; 4 Department of Anesthesiology, Minami Machida Hospital, Machida, Japan; 5 Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, Niigata, Japan


A quadricuspid aortic valve (QAV) is a rare congenital aortic valve anomaly. Here we describe a case of a patient with a QAV associated with severe aortic, mitral, and tricuspid regurgitations that were treated surgically. Transesophageal echocardiography clearly demonstrated a QAV. The aortic vlave was excised and replaced with an 18-mm ATS AP360 valve (ATS Medical Inc., Minneapolis, MN), and the mitral valve was replaced with a 29-mm St. Jude valve (St. Jude Medical Inc., St. Paul, MN). Subsequently, tricuspid annuloplasty was performed with a 30-mm MC3 ring (Edwards LifeSciences, Irvine, CA) for annular enlargement. The patient’s postioperative course was uneventful. Despite the widespread use of cardiac echocardiography, some cases of a QAV are incidentally detected during surgery. As a QAV can be associated with other congenital malformations, it is crucial to diagnose a QAV accurately using a combination of available imaging modalities, prior to surgery.

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