Erena C, Breithardt O A, Franke A, Flachskampf F A
Medizinische Klinik I der RWTH, Aachen.
Z Kardiol. 1996 Nov;85(11):889-92.
The case of a quadricuspid aortic valve diagnosed in adult age is reported. A 67-year-old patient, who had no previous diseases or cardiovascular complaints, presented in the clinic for an embolic occlusion of the left retinal artery. Isolated moderate aortic regurgitation was diagnosed clinically and echocardiographically. For its further evaluation and for seeking embolic sources, multiplane transesophageal echocardiography was performed, which discovered a quadricuspid aortic valve as the cause of aortic regurgitation and major atherosclerotic lesions in the ascending aorta and the aortic arch as possible cause of the embolic event. The fourth, accessory cusp, smaller than the other three, was localized between the non-coronary and left coronary cusp. In the short axis view the quadricuspid aortic valve showed in diastole a "X"-configuration, with a persistent central orifice between the commissures, which was the cause of the regurgitation jet in color Doppler examination, and in the systole a trapezoid opening pattern. In the long-axis view the valve showed a tricuspid closing pattern. The quadricuspid aortic valve can be exactly diagnosed by multiplane transesophageal echocardiography.
报告一例成年期诊断出的四叶式主动脉瓣病例。一名67岁患者，既往无疾病史及心血管方面的主诉，因左视网膜动脉栓塞性闭塞前来诊所就诊。临床及超声心动图诊断为单纯中度主动脉瓣反流。为进一步评估及寻找栓子来源，进行了多平面经食管超声心动图检查，发现四叶式主动脉瓣是主动脉瓣反流的原因，升主动脉及主动脉弓的主要动脉粥样硬化病变可能是栓塞事件的原因。第四个附属瓣叶小于其他三个瓣叶，位于无冠瓣叶和左冠瓣叶之间。在短轴视图中，四叶式主动脉瓣在舒张期呈“X”形，瓣叶交界处之间有持续的中央开口，这是彩色多普勒检查中反流束的原因，在收缩期呈梯形开口模式。在长轴视图中，瓣膜显示三尖瓣关闭模式。多平面经食管超声心动图可准确诊断四叶式主动脉瓣。
