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J Thorac Cardiovasc Surg 2004;128:759-760
© 2004 The American Association for Thoracic Surgery
Brief communication |
a Department of Cardiovascular Surgery, Saga Prefectural Hospital, Koseikan, Saga, Japan
Received for publication March 17, 2004; accepted for publication March 30, 2004.
* Address for reprints: Kozo Naito, MD, Department of Cardiovascular Surgery, Saga Prefectural Hospital, Koseikan, 1-12-9 Mizugae, Saga 840-8571, Japan
kozonaito@hotmail.com
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Quadricuspid aortic valve is a rare congenital anomaly. Most cases have been discovered as an incidental finding at aortic valve surgery or at autopsy. With advances in echocardiography, more cases now being discovered preoperatively. Valvular insufficiency is the most frequent hemodynamic abnormality in patients with a quadricuspid aortic valve. Most patients require aortic valve replacement, and only a few cases of surgical aortic valve repair have been reported.1,2 We report a case of quadricuspid aortic valve associated with aortic regurgitation and ascending aortic aneurysm. Aortic valve repair and ascending aorta replacement with plication of the sinotubular junction were performed successfully.
Clinical summary
A 70-year-old-woman was noted during a routine medical examination to have a diastolic murmur and was referred to our hospital for further assessment. The chest radiograph showed moderate cardiomegaly, with a cardiothoracic ratio of 0.67. Transthoracic echocardiography demonstrated severe aortic regurgitation and quadricuspid aortic valves. Chest computed tomography showed an ascending aortic aneurysm (45 mm in diameter) and dilatation of the sinotubular junction (34 mm in diameter). Transesophageal echocardiography confirmed a quadricuspid valve with three
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