scholarly journals Quadricuspid Aortic Valve Defined by Echocardiography and Cardiac Computed Tomography

2012 ◽  
Vol 6 ◽  
pp. CMC.S8952 ◽  
Author(s):  
Daniel W. Karlsberg ◽  
Yaron Elad ◽  
Robert M. Kass ◽  
Ronald P. Karlsberg
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Invasive Coronary Angiography ◽  
Aortic Insufficiency ◽  
Dynamic Imaging ◽  
Quadricuspid Aortic Valve ◽  
Severe Aortic Regurgitation

A 54 year old female presented with lower extremity edema, fatigue, and shortness of breath with physical findings indicative of advanced aortic insufficiency. Echocardiography showed severe aortic regurgitation and a probable quadricuspid aortic valve. In anticipation of aortic valve replacement, cardiac computed tomography (Cardiac CT) was performed using 100 kV, 420 mA which resulted in 6 mSv of radiation exposure. Advanced computing algorithmic software was performed with a non-linear interpolation to estimate potential physiological movement. Surgical photographs and in-vitro anatomic pathology exam reveal the accuracy and precision that preoperative Cardiac CT provided in this rare case of a quadricuspid aortic valve. While there have been isolated reports of quadricuspid diagnosis with Cardiac CT, we report the correlation between echocardiography, Cardiac CT, and similar appearance at surgery with confirmed pathology and interesting post-processed rendered images. Cardiac CT may be an alternative to invasive coronary angiography for non-coronary cardiothoracic surgery with the advantage of providing detailed morphological dynamic imaging and the ability to define the coronary arteries non-invasively. The reduced noise and striking depiction of the valve motion with advanced algorithms will require validation studies to determine its role.

scholarly journals Quadricuspid Aortic Valve Combined with Moderate Ascending Aortic Dilatation

Aorta ◽  
2015 ◽  
Vol 03 (06) ◽  
pp. 187-190 ◽  
Author(s):  
Vladimir Uspenskiy ◽  
Alexei Osadchii ◽  
Mikhail Gordeev
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Insufficiency ◽  
Computed Tomographic Angiography ◽  
Aortic Dilatation ◽  
Quadricuspid Aortic Valve ◽  
Severe Aortic Regurgitation ◽  
Computed Tomographic ◽  
Tomographic Angiography

AbstractThe quadricuspid aortic valve is a very uncommon malformation associated with aortic insufficiency, aortic stenosis, endocarditis, and ascending aortic dilatation. We report four cases of this aortic valve malformation. One patient with severe aortic regurgitation and moderate aortic dilatation required aortic valve replacement. Three patients had mild or moderate aortic insufficiency combined with moderate ascending aortic dilatation. These patients were referred to follow-up. The presented cases demonstrate that this aortic valve malformation may not be as rare as it appears and that attention must be paid to any quadricuspid findings during computed tomographic angiography and echocardiography.

Cardiac Computed Tomography – Cardiologists and Radiologists – Together Is Better for Patients

2009 ◽  
Vol 5 (2) ◽  
pp. 23
Author(s):  
Hug Cuéllar-Calàbria ◽  
Río Aguilar-Torres ◽  
◽  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
New Technology ◽  
Invasive Coronary Angiography ◽  
Non Invasive ◽  
Clinical Events ◽  
And Training ◽  
Rapid Transformation

A rapid transformation has occurred in cardiac imaging since the introduction of cardiac computed tomography (CT) at the beginning of the 21st century. The initial necessity for radiologists to learn how to use a new technology has been replaced by the need to apply it more efficiently, obtaining the best from the technique in more appropriate indications and in a safer manner. Interaction with cardiologists has grown even faster than the evolution of equipment and imaging protocols, allowing for more efficient sharing of knowledge and information. Cardiac CT is a recently introduced technology, so basic debates about indications, diagnostic performance and training are still ongoing. Cardiac CT is commonly performed following a multidisciplinary approach, with suboptimal results. Despite this, studies conducted to evaluate diagnostic performance and prediction of clinical events in populations examined with non-invasive coronary angiography indicate that cardiologists and radiologists are working more closely than before.

Is training essential for interpreting cardiac computed tomography?

2009 ◽  
Vol 50 (2) ◽  
pp. 194-200 ◽  
Author(s):  
J. Ripsweden ◽  
H. Mir-Akbari ◽  
E. Bacsovics Brolin ◽  
T. Brismar ◽  
T. Nilsson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Learning Curve ◽  
Predictive Value ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Invasive Coronary Angiography ◽  
Evaluation Team ◽  
Review Time ◽  
Curve Effect

Background: Cardiac computed tomography (CT) has gained increasing acceptance for diagnosing obstructive coronary artery disease (CAD). Several guidelines have been published on required education for proficiency in the interpretation of these examinations. Purpose: To describe the learning-curve effect of the interpretation of 100 consecutive cardiac CT examinations aimed at diagnosing CAD. The diagnostic accuracy of radiologists and radiographers was also compared. Material and Methods: Two radiologists and two radiographers, all with no prior experience in evaluation of cardiac CT, independently underwent a dedicated training program of 100 examinations randomized into 10 blocks (sessions), with 10 cases in each. They independently evaluated the coronary arteries regarding significant obstructive CAD. After every session, individual feedback on diagnostic accuracy and comparison with the corresponding invasive coronary angiography (currently regarded as the gold standard to detect coronary lesions) was given. The time required for interpretation was recorded. Results: The mean review time decreased ( P<0.0001) successively during the 10 sessions for all the observers together. The first session had a mean review time of 32 min, and the last session 16 min. No significant improvement in sensitivity, specificity, or negative predictive value (NPV) was observed. For positive predictive value (PPV), there was an improvement for the radiologists ( P<0.05), but not for the radiographers. The radiographers had a higher total specificity compared to the radiologists ( P<0.01). Conclusion: The review time for novices in cardiac CT was approximately halved during the first 100 cases, with maintained accuracy. There was a learning-curve effect in PPV for the radiologists. The diagnostic accuracy of dedicated radiographers indicates that they might be considered to be included as part of the evaluation team.

scholarly journals WCC 2017-C-109: Congenital Quadricuspid Aortic Valve Associated with Severe Aortic Regurgitation: A Rare Case Report

2017 ◽  
Vol 02 (S 01) ◽  
pp. S13-S15
Author(s):  
Pavaneel Bhandary ◽  
Palanki Satyagopal ◽  
Muppiri Kumar ◽  
Ravinuthala Kumar
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Male Patient ◽  
Rare Case ◽  
Aortic Insufficiency ◽  
Quadricuspid Aortic Valve ◽  
Severe Aortic Regurgitation ◽  
Rare Case Report

AbstractQuadricuspid aortic valve is a very rare congenital valvular anomaly. Most of these cases present with aortic insufficiency. We present a 38 year old male patient with aquadricuspid aortic valve with severe aortic regurgitation.

A case of quadricuspid aortic valve with severe aortic regurgitation diagnosed by transthoracic echocardiography

Choonpa Igaku ◽  
2011 ◽  
Vol 38 (4) ◽  
pp. 461-464
Author(s):  
Koutatsu NOMURA ◽  
Yoshikazu YAZAKI ◽  
Masako MIYASHITA ◽  
Sachiko OOTSUKI ◽  
Yutaka KUMAGAI ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Transthoracic Echocardiography ◽  
Quadricuspid Aortic Valve ◽  
Severe Aortic Regurgitation

Quadricuspid Aortic Valve Repair Facilitated by Geometric Ring Annuloplasty

2021 ◽  
pp. 155698452110030
Author(s):  
Joseph A. McGuire ◽  
Heather K. Hayanga ◽  
Jeremiah W. Hayanga ◽  
Daniel Sloyer ◽  
Matthew Ellison ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Patient Outcomes ◽  
Systematic Approach ◽  
Aortic Insufficiency ◽  
Aortic Valve Repair ◽  
Autologous Reconstruction ◽  
Quadricuspid Aortic Valve ◽  
Valve Repair ◽  
Ring Annuloplasty ◽  
Annular Geometry

Quadricuspid aortic valve (QAV) is a rare congenital anomaly often associated with aortic insufficiency. The exact anatomy of QAV is variable, and most cases have undergone aortic valve replacement. With the recognition that aortic valve repair achieves superior patient outcomes as compared to replacement, a systematic approach to autologous reconstruction of QAV is needed. This article reports 2 cases having successful repair utilizing geometric aortic annuloplasty rings, and describes a proposed scheme for repairing most QAV defects, based on relative leaflet and commissural characteristics. Using either tri-leaflet or bicuspid ring annuloplasty, the normal sub-commissural triangles can be remodeled into a 120° or 180° configuration, respectively, and then the leaflets can be sutured and plicated to fit annular geometry. With this approach, most quadricuspid valves potentially could undergo autologous reconstruction.

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