AORTIC-VALVE REPLACEMENT FOR QUADRICUSPID AORTIC-VALVE INCOMPETENCE

Quadricuspid aortic valve is an uncommon cause of aortic regurgitation . We report two patients who underwent aortic valve replacement becaus e of severe aortic incompetence; the presence of a quadricuspid aortic valve was an accidental surgical finding. In one patient the aortic v alve comprised two equal-sized larger cusps and two equal-sized smalle r cusps, while in the other it comprised three cusps of similar size a nd a small accessory cusp between the right and non-coronary cusps. Th is report confirms the rarity of the disease and the fact that patient s with quadricuspid aortic valves characterized by cusps of different sizes are more prone to develop progressive aortic incompetence becaus e of unequal distribution of stresses on the valve. Therefore, such pa tients should undergo periodic, life-time echocardiographic assessment once this malformation is detected.