Tricuspidization of Quadricuspid Aortic Valve

Williams, Livia; Peters, Paul C.; Shah, Pallav

doi:10.1016/j.athoracsur.2012.08.019

Cited by 6 publications

(10 citation statements)

References 5 publications

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“…[ 57 ] introduced their technique of neocusp creation by trimming the glutaraldehyde-treated autologous pericardium. Williams et al [ 58 ] included abnormal commissure detachment, thickened tissue excision, leaflet approximation and subcommissural annuloplasty in their surgical technique of aortic valve repair. Song et al [ 55 ] presented their tricuspidization of QAV for eight consecutive patients with an at least moderate AR.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Quadricuspid Aortic Valve: A Comprehensive Review

Yuan¹

2016

Brazilian Journal of Cardiovascular Surgery

109

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Quadricuspid aortic valve (QAV) is a rare congenital heart disease. The functional status of QAV is predominantly a pure aortic regurgitation. Clinical manifestations of patients with a QAV depend on the functional status of the QAV and the associated disorders. Significant valvular regurgitation and (or) stenosis is often present with subsequent operation performed at the fifth to sixth decade of life. The functional status of QAV is predominantly regurgitant; whereas pure stenotic QAV can be as few as in only 0.7% of the patients. QAV is usually an isolated anomaly, but other congenital heart defects can be present in 18-32% of the patients. About one-fifth of them require a surgical operation. Tricuspidalization is a preferred technique for QAV repair. As not all the patients with a QAV necessarily warrant a surgical operation, decision-making in patient selection and surgical procedure of choice are crucial. Antibiotic prophylaxis against infective endocarditis is necessary in the QAV patients with unequal-sized cusps.

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Section: Surgical Techniquesmentioning

confidence: 99%

“…Their surgical key points are pericardial leaflet reconstruction, sinotubular junction reduction and commissure coaptation suture. The latter two teams [ 55 , 58 ] emphasized the importance of subcommissural annuloplasty and sinotubular fixation in the maintenance of the coaptation of the neocusps.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Quadricuspid Aortic Valve: A Comprehensive Review

Yuan¹

2016

Brazilian Journal of Cardiovascular Surgery

109

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“…In type III, it lies between the left and noncoronary cusps, and in type IV, the supernumerary cusp cannot be identified as there are 2 equal sized smaller cusps. It is important to note that the position of the accessory cusp has no effect on the severity of the valvular insufficiency [4, 12]. Based on these classifications, our first patient had Hurwitz type C and Nakamura type IV while the second patient likely has Hurwitz type A and Nakamura type I quadricuspid aortic valve.…”

Section: Discussionmentioning

confidence: 99%

“…Quadricuspid aortic valve (QAV) usually presents as an isolated congenital anomaly, but other associated cardiac anomalies have been reported in about 18-32% of cases including aortic root dilatation [13], tetralogy of Fallot [14], patent ductus arteriosus [15], atrial and ventricular septal defects [16, 17], and anomalous origin of the coronary arteries [12].…”

Section: Discussionmentioning

confidence: 99%

Quadricuspid Aortic Valve: Report of Two Cases and Brief Review

Oladiran

Nwosu

Dhital

et al. 2019

Case Reports in Cardiology

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Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect characterized by the presence of four aortic valve leaflets of equal or varying sizes. Even rarer is its clinical presentation with aortic stenosis. Diagnosis of QAV could be challenging but is of great importance as patients often present with progressive aortic regurgitation. We present 2 cases of QAV presenting differently: one with aortic stenosis requiring valve replacement and the other with aortic regurgitation requiring close monitoring.

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“…The predominant clinical findings and management issues in QAV relate to progressive AR with aging due to progressive leaflet fibrosis and progressive failure of leaflet coaptation. The quadricuspid aortic valve is replaced in the majority of patients requiring surgery; only a few cases of in situ surgical repair have been reported [8-10]. Schmidt et al [11] reported surgical plasty repair via tricuspidization in two cases with two normal sized leaflets and two smaller leaflets using a combination of leaflet fusion, resection of the interposed commissure, and, in one patient, patch augmentation.…”

Section: Discussionmentioning

confidence: 99%

Mid-term results in patients having tricuspidization of the quadricuspid aortic valve

Song

Yang

Lee

et al. 2014

J Cardiothorac Surg

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BackgroundQuadricuspid aortic valve (QAV) is a rare congenital anomaly. We investigate the mid-term results of aortic valve reconstruction by tricuspidization in patients with QAV.MethodsWe analyzed the outcome of eight consecutive patients who underwent aortic valve reconstruction surgery (AVRS) with pericardial leaflets with symptomatic quadricuspid aortic valve (QAV) disease between December 2007 and May 2012. AVRS consists of leaflet reconstruction and fixation of the sino-tubular junction in order to maintain coaptation of the new valve.ResultsSix males and two females were included; ages ranged from 19 to 63 years (mean age, 51 years). According to Hurwitz and Roberts’s classification, three patients had type A, three patients had type B, one patient had type C, and one patient had type E. All patients had significant aortic regurgitation (AR): moderate in three patients, moderate to severe in one patient, and severe in four patients. Concomitant ascending aorta wrapping with an artificial vascular graft was performed in one case. There was no occurrence of mortality during the follow-up period (42.4 ± 18.0 months). No redo-operation was required. The NYHA functional class showed improvement from 2.1 ± 0.2 to 1.1 ± 0.2 (p = 0.008). The latest echocardiograms showed AR absent or trivial in seven patients, and mild in one patient. The aortic valve orifice area index (AVAI) was 1.03 ± 0.49 cm2/m2. Compared with preoperative echocardiograms, the left ventricular (LV) ejection fraction showed improvement from 57.6 ± 17.0 to 63.7 ± 13.2% (p = 0.036); the end-diastolic and end-systolic LV dimensions showed a significant decrease, from 63.5 ± 9.6 to 49.5 ± 3.1 mm (p = 0.012) and 43.6 ± 11.8 to 32.1 ± 5.4 mm (p = 0.012), respectively.ConclusionIn patients with QAV, AVRS with tricuspidization showed satisfactory early and mid-term results. Long-term follow-up will be necessary in order to study the durability of AVRS; however, it can be considered as a potential standard procedure.

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Tricuspidization of Quadricuspid Aortic Valve

Cited by 6 publications

References 5 publications

Quadricuspid Aortic Valve: A Comprehensive Review

Quadricuspid Aortic Valve: A Comprehensive Review

Quadricuspid Aortic Valve: Report of Two Cases and Brief Review

Mid-term results in patients having tricuspidization of the quadricuspid aortic valve

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