Abstract
A case of quadricuspid aortic valve is reported. The anomaly was unexpectedly found during surgery for aortic valve replacement in a 33-year-old man with aortic insufficiency. The supernumerary cusp was positioned between the right and the left coronary cusps. These three cusps were fairly uniform, although the non-coronary cusp was smaller. The cusps were excised and replaced with a Björk-Shiley valve. Congenital quadricuspid aortic valve is a rare abnormality, and only 39 cases have been reported. Most patients developed aortic insufficiency after reaching adulthood and nine patients had aortography or echocardiography. We propose to group congenital quadricuspid aortic valve into two types. Type 1: the supernumerary cusp is located anteriorly, that is, between the right and the left coronary cusps. The present case belongs to this type. Type 2: the supernumerary cusp is posterior and is situated between the right and the non-coronary cusps. In this type, the supernumerary cusp is always smaller than the other cusps.
