Aortic valve replacement in a 38-year-old woman with quadricuspid aortic valve led to preserved ventricular function at 8 months, prompting a novel ostia-oriented UIC classification system.
Case Report (n=1)
No
A novel UIC classification system for quadricuspid aortic valve incorporates coronary ostial assessment to guide surgical planning and complement existing morphological systems.
Quadricuspid aortic valve (QAV) is a rare congenital anomaly. While existing classifications (Hurwitz, Nakamura) describe cusp morphology, they fail to address coronary ostial involvement, a major determinant of surgical risk. We present a 38 year-old woman with severe aortic insufficiency (AI) due to Type 3 QAV (Nakamura classification) who underwent aortic valve replacement. Preoperative echocardiography confirmed four equal cusps. Based on this case and literature review, we developed the University of Illinois at Chicago (UIC) classification system for QAV, focused on the spatial relationship between cusps and coronary ostia. The UIC classification defines four classes: Class 1 (non-ostial involvement, repair feasible), Class 2 (ostial-proximate, complex repair or replacement with coronary protection), Class 3 (ostial-obstructing, replacement with possible reimplantation or CABG), and Class 4 (fenestrated/redundant, risk of dynamic obstruction or embolization). The patient’s postoperative course was uneventful, with preserved ventricular function at 8 months. The UIC classification incorporates coronary ostial assessment into QAV management, complementing existing morphological systems and guiding surgical planning. Prospective validation in larger cohorts is warranted.
Durgam et al. (Wed,) conducted a case report in Quadricuspid aortic valve (QAV) (n=1). Aortic valve replacement was evaluated on Postoperative course and ventricular function. Aortic valve replacement in a 38-year-old woman with quadricuspid aortic valve led to preserved ventricular function at 8 months, prompting a novel ostia-oriented UIC classification system.