Introduction
Quadricuspid Aortic Valve (QAV) is a rare anomaly in cardiac valvular structure, characterized by the presence of four cusps instead of the typical three. The prevalence of QAV is estimated to be approximately 1 in 8,000 cases. Various classifications exist based on structural variations, with the traditional method established by Hurwitz and Roberts. Patients with QAV commonly experience cardiac functional abnormalities, notably a tendency towards aortic regurgitation.
Scan Technique
CT scans not only reveal valve morphology but can also delineate stenosis and regurgitation through 4D cardiac imaging. All patients underwent scanning using a SOMATOM Force Dual Source (DSCT) scanner manufactured by Siemens Healthineers in Munich, Germany, employing the adaptive prospective CorAdSeq mode. The prospective ECG-triggered sequence (CorAdSeq) protocol in DSCT aids in acquiring high-quality images. The highest native temporal resolution facilitated the study without the need for intravenous or oral beta-blockers. Imaging was conducted using Care kV (auto low kV adaptation) at 70 kVand Care Dose 4D (mA modulation), resulting in extremely low radiation dose and a minimal 25cc contrast medium usage.
Study discussion – Quadricuspid aortic valve (QAV)
A 28-year-old male presented with chest pain, and ultrasound revealed clinical evidence of significant aortic regurgitation, prompting further evaluation through CT coronary and morphological assessment. The imaging illustrated the classification of an equally sized Quadricuspid aortic valve.
• Collimation: 2 x 192 x 0.6 mm
• Rotation time: 0.25 s
• Tube setting: 70 kV, 372 mAs
• Total DLP: 284 mGy
• CTDIvol: 14.06 mGy
• Amount of contrast injected for coronary exam: 25 ml (5 ml/sec)
• Heart rate: 60 bpm.
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