Quadricuspid Aortic Valve Plasty: Is it Worth it to Repair as an Alternative to Substitution?

Daprati, Andrea; Generali, Tommaso; Arlati, Francesco; Roberto, Maurizio

doi:10.1016/j.athoracsur.2012.06.036

Cited by 14 publications

(13 citation statements)

References 1 publication

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“…The inappropriate juxtaposition and abnormal stress of the valves can cause progressive valvular deterioration and eventually result in progressive AR,1–3 so there is a need for close follow-up even in patients presenting with only mild AR. In addition to valvular abnormalities, 18% of patients with QAV may have other associated cardiovascular abnormalities such as patent ductus arteriosus, atrial or VSDs and other valvular defects, such as the presence of VSD as in our patient 1 2…”

Section: Discussionmentioning

confidence: 72%

“…Although abnormal valvular function is seen in all types of QAV, the lowest incidence of abnormal valvular function is found in those with type B (67.5%) 4. Better surgical results have been shown in patients without endocarditis or aortic valve stenosis 2. The inappropriate juxtaposition and abnormal stress of the valves can cause progressive valvular deterioration and eventually result in progressive AR,1–3 so there is a need for close follow-up even in patients presenting with only mild AR.…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact embryological cause of QAV is uncertain, proposed mechanisms included abnormal septation of the conotruncus and abnormal septation or excavation in the three normal aortic valve cushions 2 4. On the basis of the variation in size of the aortic cusps, QAV has been classified into seven types.…”

Section: Discussionmentioning

confidence: 99%

“…QAV is characterised by the presence of four aortic cusps of varying sizes. Clear delineation of the anatomy of the QAV is difficult but of great clinical importance as these patients may present with progressive aortic regurgitation (AR) and other cardiovascular abnormalities 1 2. We present a case of QAV in an asymptomatic patient who presented with a murmur on routine examination.…”

Section: Introductionmentioning

confidence: 99%

“…Since first reported in 1862, quadricuspid aortic valve (QAV) remains rare with a reported incidence of 0.008–0.033% on autopsy; however, the actual incidence of QAV is underestimated 1 2. QAV is characterised by the presence of four aortic cusps of varying sizes.…”

Section: Introductionmentioning

confidence: 99%

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Quadricuspid aortic valve: a rare but important abnormality

Juan

Waller

Shah

et al. 2014

Postgraduate Medical Journal

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Quadricuspid aortic valve: a rare but important abnormality

Juan

Waller

Shah

et al. 2014

Postgraduate Medical Journal

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Which Aortic Valve Can Be Surgically Reconstructed?

et al. 2021

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Purpose of Review Preservation or repair of the aortic valve has evolved dynamically in the past 20 years. It leads to a high freedom from valve-related complications if an adequate valve durability can be achieved; it may possibly also improve survival. To date, little structured information is available about which valves can be repaired and which should better be replaced. Recent Findings For surgical decision-making, the size of the aortic root is important and the anatomy of the aortic valve must be considered. In the presence of root aneurysm, most tricuspid and bicuspid aortic valves can be preserved. In aortic regurgitation and normal aortic dimensions, the majority of tricuspid and bicuspid aortic valves can be repaired with good long-term durability. In bicuspid aortic valves, the morphologic characteristics must be taken into consideration. Unicuspid and quadricuspid aortic valves can be repaired in selected cases. Generally, cusp calcification is a sign of a poor substrate for repair; the same is true for cusp retraction and cusp destruction due to active endocarditis. They are associated with limited valve durability. Summary Using current concepts, many non-calcified aortic valves can be repaired. Modern imaging, in particular three-dimensional transesophageal echocardiography (TEE), should be able to define repairable aortic valves with a high probability.

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Early failure of quadricuspid aortic valve tricuspidization due to dehiscence of approximating coronary cusps

2014

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A 48-year-old woman diagnosed with aortic regurgitation showing a quadricuspid aortic valve (QAV) underwent repair with tricuspidization. Two non-coronary cusps (NCC) with fenestrations were detected intraoperatively. Tricuspidization of QAV was performed by approximating the two NCCs via interrupted sutures. The aortic annulus was plicated by subcommissural annuloplasty. The residual aortic regurgitation was mild, with a vena contracta of 2.1 mm. On postoperative day 5, echocardiography demonstrated a new regurgitation from the middle of the neo-NCC, and increased central regurgitation. Intraoperative findings showed the dehiscence of approximating sutures of the neo-NCC. Mechanical valve replacement was performed uneventfully.

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Quadricuspid Aortic Valve Plasty: Is it Worth it to Repair as an Alternative to Substitution?

Cited by 14 publications

References 1 publication

Quadricuspid aortic valve: a rare but important abnormality

Quadricuspid aortic valve: a rare but important abnormality

Which Aortic Valve Can Be Surgically Reconstructed?

Early failure of quadricuspid aortic valve tricuspidization due to dehiscence of approximating coronary cusps

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