J Cardiovasc Ultrasound.  2017 Mar;25(1):34-37. 10.4250/jcu.2017.25.1.34.

Quadricuspid Aortic Valve Complicated with Severe Aortic Regurgitation and Left-Sided Inferior Vena Cava

• Shiraishi
• Okawa K
• Muguruma K
• Ito D
• Kimura M
• Kishita E
• Nakagawa Y
• Hyogo M
• Takahashi
• Sawada T

• KMID: 2375295
• DOI: http://doi.org/10.4250/jcu.2017.25.1.34

Abstract

No abstract available.

Keyword

Quadricuspid aortic valve; Transesophageal echocardiography; Left-sided inferior vena cava

MeSH Terms

Aortic Valve Insufficiency*
Aortic Valve*
Echocardiography, Transesophageal
Vena Cava, Inferior*

Figure

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  Fig. 1 Quadricuspid aortic valve with severe aortic regurgitation. A and B: Two-dimensional transesophageal echocardiography images during diastolic phase (A, short-axis view; B, long-axis view). C: Three-dimensional transesophageal echocardiography images (left, diastolic; right, systolic). D: Intraoperative photograph showing quadricuspid aortic valve and left main ostium (white arrow). The accessory cusp was located between the left coronary cusp and the non-coronary cusp. E: Surgically resected leaflets of the quadricuspid aortic valve showing 1 larger cusp (R), 2 intermediate cusps (L and N), and 1 smaller cusp (Ac), corresponding to type D based on the Hurwitz and Roberts' classification. Ac: accessory cusp, L: left coronary cusp, N: non-coronary cusp, R: right coronary cusp.

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  Fig. 2 Pre-operative cardiac catheterization. Coronary angiography (CAG) (A, right CAG; B, left CAG) and aortography (C, end-diastolic; D, end-systolic) depicted a significant stenosis in the distal segment of right coronary artery and aortic regurgitation of Sellers grade 3, respectively.

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  Fig. 3 Pre-operative computed tomography images indicating the left-sided inferior vena cava (IVC) (left: reconstructed 3-dimensional image, right: transverse image). The IVC (white arrows) ran upward along the left side of the aorta (A), crossed the aorta anteriorly through the meso-aortic angle (B), and communicated with a normally positioned infra-hepatic IVC (C).

Reference

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