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Related Experiment Videos

Infective endocarditis associated with quadricuspid aortic valve.

Norifumi Takeda1, Eiji Ohtaki, Hitoshi Kasegawa

  • 1Department of Cardiology, Sakakibara Heart Institute, Shibuya-ku, Tokyo 151-0053, Japan.

Japanese Heart Journal
|June 27, 2003
PubMed
Summary

A rare quadricuspid aortic valve (QAV) in a young woman led to aortic regurgitation. This case suggests patients with unequal small cusps may be prone to endocarditis.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Aortic valve regurgitation can be caused by various factors, including congenital abnormalities.
  • Quadricuspid aortic valve (QAV) is a rare congenital anomaly with varying clinical presentations.
  • Endocarditis is a serious infection that can affect heart valves.

Observation:

  • A 26-year-old Japanese woman presented with new aortic regurgitation following a high fever of unknown origin.
  • Despite negative blood cultures, fever resolved with intravenous panipenem/betamipron (PAPM/BP).
  • Echocardiography and surgery identified a quadricuspid aortic valve (QAV) with a damaged smaller accessory cusp.

Findings:

  • The patient had a type 'f' quadricuspid aortic valve with two equal larger cusps and two unequal smaller cusps.

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  • The damaged cusp showed no active vegetation, despite the preceding febrile illness.
  • A Medtronic Freestyle bioprosthesis was implanted via a subcoronary technique.

    • Implications:

    • This case highlights a potential association between quadricuspid aortic valves, particularly those with unequal small cusps, and endocarditis.
    • Further research is needed to fully understand the endocarditis risk in patients with QAV.
    • Early recognition and management of QAV abnormalities are crucial for preventing severe cardiac complications.