Key result
Multimodality imaging incidentally detects a rare quadricuspid aortic valve with severe AR and LV dilatation.
Case Report (n=1)
Highlights the importance of multimodality imaging in detecting and assessing rare congenital anomalies like quadricuspid aortic valve.
May warrant aortic valve assessment during TOE prior to AF cardioversion; leaves open natural history and intervention timing in QAV with severe AR.
Quadricuspid aortic valve (QAV) is a rare congenital anomaly associated with progressive aortic regurgitation. A 57-year-old man underwent transoesophageal echocardiography prior to cardioversion for newly diagnosed atrial fibrillation, which revealed an incidental QAV with incomplete cusp coaptation and a central defect. Colour Doppler demonstrated a broad, eccentric regurgitant jet occupying the left ventricular outflow tract along the septum and extending to the mid left ventricle. Despite a vena contracta of 5 mm, multimodal assessment confirmed severe regurgitation. Transthoracic echocardiography showed left ventricular dilatation (LVEDD 64 mm) and early remodeling with borderline systolic function. No aortic root abnormalities were present. The patient was referred for surgical valve repair, highlighting the importance of multimodality imaging in QAV.
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Ara Baizel (2026) conducted a case report in Quadricuspid aortic valve with severe aortic regurgitation (n=1). Multimodality imaging (transoesophageal and transthoracic echocardiography) was evaluated. Multimodality imaging prior to cardioversion incidentally detected a rare quadricuspid aortic valve with severe regurgitation and left ventricular dilatation (LVEDD 64 mm) in a 57-year-old man.
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