A Cadaveric Case Report of a Quadricuspid Pulmonary Valve and Its Clinical Implications

A quadricuspid pulmonary valve (QPV) is a rare congenital anomaly resulting from abnormal semilunar valvulogenesis during embryonic development. Most reported cases are identified incidentally at autopsy, and the condition remains likely underrecognized clinically because of the pulmonary valve's retrosternal location and limited visualization on transthoracic echocardiography. We report a cadaveric case of a Hurwitz type F QPV identified during a routine dissection of a 78-year-old female donor. Gross examination revealed two larger cusps and two unequal smaller anterior cusps associated with mild dilation of the pulmonary trunk. No evidence of pulmonary stenosis, right ventricular hypertrophy, or pulmonary artery aneurysm (PAA) was observed. This report reviews the embryologic basis, morphologic classification, diagnostic challenges, clinical associations, and management considerations of QPV. Although many QPVs remain asymptomatic, the anomaly has been associated with congenital cardiac defects, pulmonary regurgitation, PAA, and rare surgical implications, including use in the Ross procedure. Recognition of QPV variants is important for accurate diagnosis, risk assessment, and individualized surgical planning. We aim to contribute to the currently limited body of literature relating to this uncommon anomaly with cadaveric insights of one of the rarest variations of the QPV.