QUADRICUSPID AORTIC-VALVE DIAGNOSED BY MU LTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

The case of a quadricuspid aortic valve diagnosed in adult age is repo rted. A 67-year-old patient, who had no previous diseases or cardiovas cular complaints, presented in the clinic for an embolic occlusion of the left retinal artery. Isolated moderate aortic regurgitation was di agnosed clinically and echocardiographically. For its further evaluati on and for seeking embolic sources, multiplane transesophageal echocar diography 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 e mbolic event. The fourth, accessory cusp, smaller than the other three , was localized between the non-coronary and left coronary cusp. In th e short axis view the quadricuspid aortic valve showed in diastole a ' 'X''-configuration, with a persistent central orifice between the comm issures, which was the cause of the regurgitation jet in color Doppler examination, and in the systole a trapezoid opening pattern. In the l ong-axis view the valve showed a tricuspid closing pattern. The quadri cuspid aortic valve can be exactly diagnosed by multiplane transesopha geal echocardiography.