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Aortic valve replacement for quadricuspid aortic valve incompetence
U Bortolotti1, G Scioti, M Levantino
1Department of Cardiology, Angiology and Pneumology, University of Pisa Medical School, Italy.
The Journal of Heart Valve Disease
|October 30, 1998
Summary
Quadricuspid aortic valve is a rare cause of aortic regurgitation. Patients with unevenly sized cusps require lifelong echocardiographic monitoring due to increased risk of aortic incompetence.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Quadricuspid aortic valve (QAV) is an infrequent congenital anomaly.
- It is a rare cause of significant aortic regurgitation and subsequent aortic incompetence.
- Surgical intervention for aortic valve replacement may reveal QAV incidentally.
Observation:
- Two cases of severe aortic incompetence due to QAV are presented.
- One QAV had two large and two small cusps; the other had three similar-sized cusps and a small accessory cusp.
- The anatomical variations in QAV cusp size were noted during aortic valve replacement surgery.
Findings:
- The presence of quadricuspid aortic valves, particularly with unequal cusp sizes, predisposes individuals to progressive aortic incompetence.
- Unequal cusp sizes lead to uneven stress distribution across the valve leaflets.
- This malformation, though rare, can result in severe hemodynamic compromise.
Implications:
- Patients diagnosed with quadricuspid aortic valves necessitate lifelong, periodic echocardiographic surveillance.
- Early detection of progressive aortic incompetence is crucial for timely intervention.
- Understanding QAV morphology is vital for predicting disease progression and managing patients effectively.