Quadricuspid pulmonic valve(QPV) is almost always a benign anomaly and is therefore usually discovered incidentally on radiographic studies or post-mortem at autopsy. Because of its rarity, the true extent of the phys...Quadricuspid pulmonic valve(QPV) is almost always a benign anomaly and is therefore usually discovered incidentally on radiographic studies or post-mortem at autopsy. Because of its rarity, the true extent of the physiology of QPV is not fully understood, and the few reported cases of it may underestimate its physiological consequences. In this case, we report on a young active-duty solider who presented for a well check-up and was discovered on imaging to have a QPV. We also review the most recent literature and provide recommendations regarding the most effective diagnostic modalities.展开更多
BACKGROUND Quadricuspid aortic valve(QAV)is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033%(<0.05%)predominantly causing aortic regurgitation.A certain number of patients(nearly one-half)...BACKGROUND Quadricuspid aortic valve(QAV)is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033%(<0.05%)predominantly causing aortic regurgitation.A certain number of patients(nearly one-half)have abnormal function and often require surgery,commonly in their fifth or sixth decade.QAV usually appears as an isolated anomaly but may also be associated with other cardiac congenital defects.Echocardiography is considered the main diagnostic method although more and more importance is given to computed tomography(CT)and magnetic resonance imaging(MRI)as complementary methods.CASE SUMMARY A 60-year-old female patient was referred for transthoracic ultrasound of the heart as part of a routine examination in the treatment of arterial hypertension.She did not have any significant symptoms.QAV was confirmed and there were no elements of valve stenosis with moderate aortic regurgitation.At first,it seemed that in the projection of the presumed left coronary cusp,there were two smaller and equally large cusps along with two larger and normally developed cusps.Cardiac CT imaging was performed to obtain an even more precise valve morphology and it showed that the location of the supernumerary cusp is between the right and left coronary cusp,with visible central malcoaptation of the cusps.Also,coronary computed angiography confirmed the right-type of myocardial bridging at the distal segment of the left anterior descending coronary artery.Significant valve dysfunction often occurs in middle-aged patients and results in surgical treatment,therefore,a 1-year transthoracic echocardiogram control examination and follow-up was recommended to our patient.CONCLUSION This case highlights the importance of diagnosing QAV since it leads to progressive valve dysfunction and can be associated with other congenital heart defects which is important to detect,emphasizing the role of cardiac CT and MRI.展开更多
Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associa...Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associated with aortic insufficiency in 68% of the cases. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are currently used as a diagnostic and follow-up method for this anomaly. The objective of the present paper is through the clinical case report of a 60 year old patient submitted to surgical correction of QAV, to relate some clinical aspects of the disease and to discuss the anesthetic management for this group of patients, in addition, emphasizing the importance and the increasing use of the TEE in the intraoperative period in cardiac surgeries.展开更多
Background Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement （AVR）. The diagnosis and treatment of the disease were reported in 11 cases. Methods Eleven patients （nine men and two ...Background Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement （AVR）. The diagnosis and treatment of the disease were reported in 11 cases. Methods Eleven patients （nine men and two women, mean age 33.4 years） with quadricuspid aortic valve were retrospectively evaluated. Medical records, echocardiograms and surgical treatment were reviewed. Results In accordance with the Hurwitz and Roberts classification, the patients were classified as type A （n=-2）, type B （n=7）, type F （n=1） and type G （n=1）. Three patients were associated with other heart diseases, including infective endocarditis and mitral prolaps, left superior vena cava, aortic aneurysm. All had aortic regurgitation （AR） except two with aortic stenosis （AS）, detected by color-flow Doppler echocardiography. The congenital quadricuspid aortic valve deformity in seven patients was diagnosed by echocardiography. All patients underwent successful aortic valve replacement. Conclusion Quadricuspid aortic valve is a rare cause of aortic insufficiency, while echocardiography plays an important role in diaanosina the disease. Aortic valve reelacement is the major therapy for the disease.展开更多
文摘Quadricuspid pulmonic valve(QPV) is almost always a benign anomaly and is therefore usually discovered incidentally on radiographic studies or post-mortem at autopsy. Because of its rarity, the true extent of the physiology of QPV is not fully understood, and the few reported cases of it may underestimate its physiological consequences. In this case, we report on a young active-duty solider who presented for a well check-up and was discovered on imaging to have a QPV. We also review the most recent literature and provide recommendations regarding the most effective diagnostic modalities.
文摘BACKGROUND Quadricuspid aortic valve(QAV)is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033%(<0.05%)predominantly causing aortic regurgitation.A certain number of patients(nearly one-half)have abnormal function and often require surgery,commonly in their fifth or sixth decade.QAV usually appears as an isolated anomaly but may also be associated with other cardiac congenital defects.Echocardiography is considered the main diagnostic method although more and more importance is given to computed tomography(CT)and magnetic resonance imaging(MRI)as complementary methods.CASE SUMMARY A 60-year-old female patient was referred for transthoracic ultrasound of the heart as part of a routine examination in the treatment of arterial hypertension.She did not have any significant symptoms.QAV was confirmed and there were no elements of valve stenosis with moderate aortic regurgitation.At first,it seemed that in the projection of the presumed left coronary cusp,there were two smaller and equally large cusps along with two larger and normally developed cusps.Cardiac CT imaging was performed to obtain an even more precise valve morphology and it showed that the location of the supernumerary cusp is between the right and left coronary cusp,with visible central malcoaptation of the cusps.Also,coronary computed angiography confirmed the right-type of myocardial bridging at the distal segment of the left anterior descending coronary artery.Significant valve dysfunction often occurs in middle-aged patients and results in surgical treatment,therefore,a 1-year transthoracic echocardiogram control examination and follow-up was recommended to our patient.CONCLUSION This case highlights the importance of diagnosing QAV since it leads to progressive valve dysfunction and can be associated with other congenital heart defects which is important to detect,emphasizing the role of cardiac CT and MRI.
文摘Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with prevalence less than 0.01% in autopsy series. It can be found as an isolated anomaly, and the patient may be asymptomatic, but is often associated with aortic insufficiency in 68% of the cases. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are currently used as a diagnostic and follow-up method for this anomaly. The objective of the present paper is through the clinical case report of a 60 year old patient submitted to surgical correction of QAV, to relate some clinical aspects of the disease and to discuss the anesthetic management for this group of patients, in addition, emphasizing the importance and the increasing use of the TEE in the intraoperative period in cardiac surgeries.
文摘Background Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement （AVR）. The diagnosis and treatment of the disease were reported in 11 cases. Methods Eleven patients （nine men and two women, mean age 33.4 years） with quadricuspid aortic valve were retrospectively evaluated. Medical records, echocardiograms and surgical treatment were reviewed. Results In accordance with the Hurwitz and Roberts classification, the patients were classified as type A （n=-2）, type B （n=7）, type F （n=1） and type G （n=1）. Three patients were associated with other heart diseases, including infective endocarditis and mitral prolaps, left superior vena cava, aortic aneurysm. All had aortic regurgitation （AR） except two with aortic stenosis （AS）, detected by color-flow Doppler echocardiography. The congenital quadricuspid aortic valve deformity in seven patients was diagnosed by echocardiography. All patients underwent successful aortic valve replacement. Conclusion Quadricuspid aortic valve is a rare cause of aortic insufficiency, while echocardiography plays an important role in diaanosina the disease. Aortic valve reelacement is the major therapy for the disease.
