Quadricuspid aortic valve

Quadricuspid aortic valve
Truncus Arteriosus With Subvalvular Interventricular Septal Defect: Gross natural color excellent view of lesion looking at opened aortic ring with quadricuspid aortic valve large subvalvular defect origin of pulmonary arteries is at forceps. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

WikiDoc Resources for Quadricuspid aortic valve
Articles
Most recent articles on Quadricuspid aortic valve Most cited articles on Quadricuspid aortic valve Review articles on Quadricuspid aortic valve Articles on Quadricuspid aortic valve in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Quadricuspid aortic valve Images of Quadricuspid aortic valve Photos of Quadricuspid aortic valve Podcasts & MP3s on Quadricuspid aortic valve Videos on Quadricuspid aortic valve
Evidence Based Medicine
Cochrane Collaboration on Quadricuspid aortic valve Bandolier on Quadricuspid aortic valve TRIP on Quadricuspid aortic valve
Clinical Trials
Ongoing Trials on Quadricuspid aortic valve at Clinical Trials.gov Trial results on Quadricuspid aortic valve Clinical Trials on Quadricuspid aortic valve at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Quadricuspid aortic valve NICE Guidance on Quadricuspid aortic valve NHS PRODIGY Guidance FDA on Quadricuspid aortic valve CDC on Quadricuspid aortic valve
Books
Books on Quadricuspid aortic valve
News
Quadricuspid aortic valve in the news Be alerted to news on Quadricuspid aortic valve News trends on Quadricuspid aortic valve
Commentary
Blogs on Quadricuspid aortic valve
Definitions
Definitions of Quadricuspid aortic valve
Patient Resources / Community
Patient resources on Quadricuspid aortic valve Discussion groups on Quadricuspid aortic valve Patient Handouts on Quadricuspid aortic valve Directions to Hospitals Treating Quadricuspid aortic valve Risk calculators and risk factors for Quadricuspid aortic valve
Healthcare Provider Resources
Symptoms of Quadricuspid aortic valve Causes & Risk Factors for Quadricuspid aortic valve Diagnostic studies for Quadricuspid aortic valve Treatment of Quadricuspid aortic valve
Continuing Medical Education (CME)
CME Programs on Quadricuspid aortic valve
International
Quadricuspid aortic valve en Espanol Quadricuspid aortic valve en Francais
Business
Quadricuspid aortic valve in the Marketplace Patents on Quadricuspid aortic valve
Experimental / Informatics
List of terms related to Quadricuspid aortic valve

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]

Overview

Quadricuspid aortic valve is a rare congenital anomaly and usually found at surgery or diagnosed preoperatively during echocardiographic examination or aortography.

The most common hemodynamic abnormality associated with this anomaly is aortic insufficiency.

Embryology

The semilunar valves are derived from mesenchymal swellings in the aortic and pulmonary trunk after the truncus arteriosus has been partitioned.

It is in the early stages of truncal separation that four subendothelial buds appear instead of three.

The presence of a corpus arnatii on all four cusps indicates that the valve resulted from abnormal embryogenesis.

History

The first known case report was written by Balington in 1862.

The prevalence of quadricuspid aortic valve is (by historical autopsy review) approximately 0.008%. A modern echocardiography database review showed the prevalence to be somewhat higher, depending on the years reviewed (0.013%–0.043%).

Pathophysiology

On pathological descriptions the aortic valve has four cusps:

• a posterior cusp,
• a left coronary cusp,
• a right coronary cusp,
• an anterior supernumerary cusp.

Raphes join the supernumerary cusp with the left and right coronary cusps. The raphes have been described as shallow and chordlike. The supernumerary cusp can have multiple fenestrations.

The cusps can vary in;

• Size,
• Thickness
• Pliability

Classification

• Four equal cusp,
• Three equal large and one small cusp (the most common type),
• Two equal large and two equal small cusps,
• One large, two equal intermediate and one small cusps,
• Three equal small and one larger cusps,
• Two equal large and two unequal smaller cusps,
• Four unequal cusps.

Associated cardiac abnormalities

• Displaced coronary ostia
• Single or accessory coronary ostia
• Isolated coronary ostium
• Patent ductus arteriosus
• Congenitally deficient mitral leaflets
• Ventricular septal defect
• Fibromuscular subaortic stenosis
• Non-obstructive hypertrophic cardiomyopathy
• Aortic insufficiency (the most common)

Diagnosis

Echocardiography

• Quadricuspid Aortic Valve 1

<googlevideo>3949482772610719752&hl=en</googlevideo>

• Quadricuspid Aortic Valve 2

<googlevideo>-751422357787911615&hl=en</googlevideo>

• Quadricuspid Aortic Valve 3

<googlevideo>7157030825633724404&hl=en</googlevideo>

• Quadricuspid Aortic Valve 4

<googlevideo>1729835828662359814&hl=en</googlevideo>

• Quadricuspid Aortic Valve 5

<googlevideo>966621058418025889&hl=en</googlevideo>

• Quadricuspid Aortic Valve 6

<googlevideo>7337985372630045044&hl=en</googlevideo>

• Quadricuspid Aortic Valve 7

<googlevideo>-5429693187408571619&hl=en</googlevideo>

• Quadricuspid Aortic Valve 8

<googlevideo>-2395092633273759677&hl=en</googlevideo>

• Quadricuspid Aortic Valve 9

<googlevideo>-1101037639424512577&hl=en</googlevideo>

Pathological Findings

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

• 

  Truncus arteriosus with Subvalvular Interventricular Septal Defect: Gross natural color excellent view of lesion looking at opened aortic ring with quadricuspid aortic valve large subvalvular defect origin of pulmonary arteries is at forceps.

References

Template:WikiDoc Sources