Abstract
Quadricuspid aortic valve is a rare congenital anomaly usually associated with regurgitation. A young woman underwent surveillance after cardiovascular magnetic resonance imaging demonstrated four equal cusps in diastole but bicuspid-type systolic opening from fusion of the left and non-coronary cusps. By 2025, eccentric regurgitation was severe on echocardiography and moderate-to-severe on magnetic resonance imaging, with a regurgitant fraction of 31% and mild left ventricular dilatation. Increasing breathlessness and declining peak oxygen uptake prompted multidisciplinary review. Valve replacement with ascending aortic support was recommended, and she was considered suitable for a Ross procedure with personalised external aortic root support.
Recommended Citation
Aneeq Ahmed, Suhail Khan, Luigia D'Errico, Beyond Cusp Count: Bicuspid Function in a Quadricuspid Aortic Valve Journal of the Hong Kong College of Cardiology 2026;33(3):122-126 https://doi.org/10.55503/2790-6744.1591
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