Quadricuspid Aortic Valve with Moderate Regurgitation

June 11, 2022
Pages 1 – 5

Quantification of aortic valve regurgitation in an asymptomatic patient with a quadricuspid aortic valve

44-year-old female patient ( BSA 1.7 m2), with intermittent atypical chest pain since 1 year. Known untreated hypertension (160/66mmHg). Smoker. Normal ECG. Recent outpatient diagnosis of quadricuspid aortic valve with severe regurgitation at a transesophageal examination (see Page 3). Started diuretic therapy. Admitted for aortic valve replacement.

Figure 1. TT 2D parasternal long axis
Figure 2. TT 2D parasternal short axis

Figure 3. TT 2D apical 4-chamber, left ventricle

The transthoracic examination shows normal size of the aortic root, ascending aorta, and arch; a quadricuspid aortic valve with minimal fibrotic thickening (Figure 2); mild left atrial dilatation (39 ml/m2); minimal fibrotic thickening of the mitral valve without functional abnormalities; normal LV biplane end-diastolic volume (73 ml/m2), end-systolic diameter (35 mm), wall thickness, segmental wall motion and biplane ejection fraction (63 %) (Figures 1 and 3 ); normal right ventricular dimensions and systolic function. The mitral annulus dimensions were normal (3.3 cm x 2.7 cm).