Open Journal of Anesthesiology, 2018, 8, 172-182
http://www.scirp.org/journal/ojanes
ISSN Online: 2164-5558
ISSN Print: 2164-5531
DOI: 10.4236/ojanes.2018.85018 May 31, 2018 172 Open Journal of Anesthesiology
Anesthetic Management for Quadricuspid
Aortic Valve Repair: Case Report and Literature
Review
Lúcia Caroline Schons Correa
1
, Érica Mendonça Reiff Carlos
1
,
Paula Cristina Leitão de Assunção
1
, José Eduardo Guimaraes Pereira
2
,
Carlos Darcy Alves Bersot
1
1
Department of Anesthesiology, Medical Sciences College at Hospital Universitário Pedro Ernesto (HUPE), Universidade do
Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
2
Department of Anaesthesiology, Botucatu Medical School, Universidade Estadual Paulista, São Paulo, Botucatu, Brazil
Abstract
Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly with
prevalence less than 0.01% in autopsy series. It can be found as an isolated
anomaly, and the patient may be asymptomatic, but is often associated with
aortic insufficiency in 68% of the cases. Transthoracic echocardiography
(TTE) and transesophageal echocardiography (TEE) are currently used as a
diagnostic and follow-up method for this anomaly. The objective of the
present paper is through the clinical case report of a 60 year old patient sub-
mitted to surgical correction of QAV, to relate some clinical aspects of the
disease and to discuss the anesthetic management for this group of patients, in
addition, emphasizing the importance and the increasing use of the TEE in
the intraoperative period in cardiac surgeries.
Keywords
Quadricuspid Aortic Valve, Anesthetic Management, Transesophageal
Echocardiography
1. Introduction
There are two classification systems for QAV: The Hurwitz & Roberts [1], in
which the QAV is classified according to the size of the supranumerary cusp into
seven categories from A to G, and to which Vali [2] has added the H type (Fig-
ure 1). And the system proposed by Nakamura et al. [3], in which the classifica-
tion is based on the position of the supranumerary cusp, whether it is located
How to cite this paper: Correa, L.C.S.,
Carlos, É.M.R., de Assunção, P.C.L., Perei-
ra, J.E.G. and Bersot, C.D.A. (2018) Anes-
thetic Management for Quadricuspid Aor-
tic Valve Repair: Case Report and Litera-
ture Review. Open Journal of Anesthesiol-
ogy, 8, 172-182.
https://doi.org/10.4236/ojanes.2018.85018
Received: March 8, 2018
Accepted: May 28, 2108
Published: May 31, 2108
Copyright © 2018 by authors and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access