Quadricuspid Aortic Valve: Intraoperative Diagnosis by Transesophageal Echocardiography

The quadricuspid aortic valve is a rare congenital anomaly, which usually progresses to aortic regurgitation in adulthood requiring aortic valve replacement. It may be associated with other congenital abnormalities such as aberrant coronary arteries, patent ductus arteriosus, ventricular septal defect, pulmonary stenosis, persistent left superior vena cava, subaortic stenosis, and aortic dilation. Most cases are diagnosed incidentally during aortic valve surgery or autopsy. With the availability of better imaging techniques such as three-dimensional echocardiography and cardiac magnetic resonance imaging, more cases are being diagnosed in asymptomatic patients. Herein, we report a case of a 55-year-old man in whom a quadricuspid aortic valve was detected by intraoperative transesophageal echocardiography.