Quadricuspid pulmonic valve found on well exam

Dunay, Stephen N; R, Roberge; Avedissian, Lena

doi:10.1186/s40779-015-0037-2

Cited by 6 publications

(11 citation statements)

References 8 publications

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“…2,5 Morphologically, QPV can be the symmetric type, with a pair of or all 4 valve leaflets of equal size, or it can be the asymmetric type, with 3 equal-sized leaflets and a small fourth leaflet, as in our case, often with fenestrations. 5 The valve tends to fail by insufficiency rather than as a result of stenosis.…”

Section: Commentmentioning

confidence: 96%

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Ross-Konno Operation in an Infant With a Quadricuspid Pulmonary Valve and Anomalous Aortic Origin of the Right Coronary Artery

Bayle

Boston

Sainathan

et al. 2020

The Annals of Thoracic Surgery

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Anomalous aortic origin of the right coronary artery from the left aortic sinus is a rare congenital anomaly that is generally repaired during adolescence when the condition is associated with symptoms. It is rarely diagnosed in infancy. Similarly, a quadricuspid pulmonary valve is also a rare finding, and there are scant data to evaluate whether this malformation of the pulmonary valve is suitable to be used for a Ross operation. This report describes a case in which both these anomalies coexisted in an infant who underwent a successful Ross-Konno operation.A quadricuspid pulmonary valve (QPV) is a rare congenital cardiac anomaly of uncertain significance, and there are scant data to evaluate whether this malformation of the pulmonary valve is suitable to be used for a Ross operation. 1-3 We describe a case in which this anomaly existed in an infant who underwent a successful Ross-Konno operation. Our patient also had an associated anomalous aortic origin of the right coronary artery (AAORCA), which made the repair somewhat more complex.A 39-week gestational age male infant weighing 3.2 kg was born with interrupted aortic arch type B, hypoplastic left heart complex, and a large posterior malaligned ventricular septal defect. The hypoplastic bicuspid aortic valve measured 4.4 mm (z score, À4.5), the left ventricular major axis was 25 mm, with a minor axis of 9 mm and a long axis of the heart of 32 mm, and the mitral valve measured 10 mm (z score, À0.87). The Congenital Heart Surgeons' Society scores of 1 and 2 favored a biventricular repair. 4 He underwent a primary repair of the interrupted aortic arch with anterior augmentation of the anastomosis using autologous treated pericardium and pericardial patch closure of a large posterior malaligned ventricular septal defect and a large atrial septal defect.His early postoperative course was uncomplicated, and he was thriving at home with good weight gain and no feeding difficulty. However, the left ventricular outflow tract obstruction continued to increase over the next 3 months. By echocardiography, the peak gradient over the subvalvular and valvar areas was recorded as 90 mm Hg, and cardiac catheterization confirmed a multilevel gradient of 60 mm Hg ( Figure 1A). In addition, the right coronary artery arose from the left sinus very close to the left main coronary artery ostium ( Figure 1B).At 4 months of age, he underwent reoperation for subaortic resection. Because the subaortic scarring involved the hypoplastic aortic valve leaflets, a Ross-Konno operation was performed. His intraoperative findings confirmed the high takeoff of the right coronary artery from the left sinus very close to the ostium of the left main coronary artery. There was an interarterial course, making the harvesting of the pulmonary root more complicated, especially in the context of reoperative aortic root surgery in an infant. Furthermore, once the pulmonary root had been harvested, it was found to be a quadricuspid valve, with a small rudimentary fourth posterior leaflet. A generous cuff...

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Section: Commentmentioning

confidence: 96%

“…It tends to be better imaged by transesophageal echocardiography and cross-sectional imaging such as magnetic resonance imaging or a computed tomographic scan. 2,5 Morphologically, QPV can be the symmetric type, with a pair of or all 4 valve leaflets of equal size, or it can be the asymmetric type, with 3 equal-sized leaflets and a small…”

mentioning

confidence: 99%

Ross-Konno Operation in an Infant With a Quadricuspid Pulmonary Valve and Anomalous Aortic Origin of the Right Coronary Artery

Bayle

Boston

Sainathan

et al. 2020

The Annals of Thoracic Surgery

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“…After publication of this work [ 1 ], we noted the second author’s name was incorrect as Robert A Roberge. The author’s correct name should be Eric A Roberge.…”

Section: Erratummentioning

confidence: 99%

Erratum: Quadricuspid pulmonic valve found on well exam

2015

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“…QPV is a rare cardiac finding that is often identified postmortem, as it is typically clinically asymptomatic. Congenital QPV is seen in 0.021% of the population, with a 2:1 incidence in men versus women ( 1 ). Anatomically, there is variation seen in QPV, the most common variant being 3 equal-size cusps with a smaller fourth cusp (60%) ( 1 ).…”

mentioning

confidence: 99%

“…Congenital QPV is seen in 0.021% of the population, with a 2:1 incidence in men versus women ( 1 ). Anatomically, there is variation seen in QPV, the most common variant being 3 equal-size cusps with a smaller fourth cusp (60%) ( 1 ). Other cases have reported 4 (12%), and 2 larger cusps with 2 smaller cusps (15%) ( 1 ).…”

mentioning

confidence: 99%