Quadricuspid aortic valve repair with a modified-tricuspidization technique

Introduction: Quadricuspid aortic valve (QAV) is an extremely rare developmental abnormality with an incidence of 0.006%. QAV is an incidental finding that in some patients (23%) may determine aortic regurgitation (AR). Altogether 16% of patients indeed require surgery with AR being the most frequent indication. Methods and results: We describe a case report of a 46 year-old female affected by severe aortic regurgitation due to QAV successfully treated with a modified-tricuspidization technique associated with cusp extension, prolapsing commissure suturing, and sub-commissural annuloplasty. Discussion: QAV repair represents an attractive perspective to overcome the drawbacks of either mechanical or biological prosthesis.