Hayakawa Masato, Asai Tohru, Kinoshita Takeshi, Suzuki Tomoaki
Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:941-4. doi: 10.5761/atcs.cr.13-00125. Epub 2014 Mar 15.
Quadricuspid aortic valve is rare, with an estimated incidence of 0.008% to 1.46%. Most cases are encountered incidentally during aortic valve surgery or autopsy. The condition frequently progresses to aortic regurgitation, which can manifest in adulthood and may require surgical treatment. This anomaly may sometimes be associated with other malformations, the most common being coronary artery anomalies. We performed a retrospective chart review of patients diagnosed with quadricuspid aortic valve between January 2002 and July 2012 and report here on cases treated surgically. We encountered three cases of quadricuspid aortic valve among 627 patients undergoing aortic valve surgery at our institution (an incidence of 0.48%). All three had aortic regurgitation and two were free of cardiac anomaly; the other had ascending aortic aneurysm and coronary malformation. According to Hurwitz's classification, two of the valves were of type b and one of type d. Under Nakamura's classification, meanwhile, two of the valves were type II and the other type III. All patients underwent successful aortic valve replacement and had uneventful postoperative courses.
四叶式主动脉瓣较为罕见，估计发病率为0.008%至1.46%。大多数病例是在主动脉瓣手术或尸检时偶然发现的。这种情况常进展为主动脉瓣反流，可在成年期出现，可能需要手术治疗。这种异常有时可能与其他畸形相关，最常见的是冠状动脉畸形。我们对2002年1月至2012年7月间诊断为四叶式主动脉瓣的患者进行了回顾性病历审查，并在此报告接受手术治疗的病例。在我们机构接受主动脉瓣手术的627例患者中，我们遇到了3例四叶式主动脉瓣病例（发病率为0.48%）。所有3例均有主动脉瓣反流，2例无心脏异常；另1例有升主动脉瘤和冠状动脉畸形。根据Hurwitz分类，其中2个瓣膜为b型，1个为d型。同时，根据中村分类，2个瓣膜为II型，另1个为III型。所有患者均成功进行了主动脉瓣置换，术后过程顺利。
