title: Surgical treatment of a pulmonary artery aneurysm due to a regurgitant quadricuspid pulmonary valve.
abstract: We report the case of a patient with a pulmonary artery (PA) aneurysm secondary to a regurgitant quadricuspid pulmonary valve, in which both lesions were successfully repaired. The patient, a 16-year old boy, was known to have had pulmonary regurgitation and progressive dilation of the PA for years. He was operated on when he developed symptoms of effort, a dilated right ventricle and a PA of 55 mm. The quadricuspid pulmonary valve was an intraoperative finding. It had a dilated annulus, two normal cusps, a third with a 'sparrow-nest' configuration and the fourth was severely hypoplastic (which explained the valve regurgitation). The valve was repaired through tricuspidisation of the quadricuspid pulmonary valve (annular plication at the level of the hypoplastic cusp, freeing of excedentary tissue from the 'sparrow-nest' cusp and its reattachment to the plicated annulus). The aneurysm was treated through a reduction pulmonary arterioplasty. Early assessment showed the minimal regurgitation of the valve and a normal diameter PA. The outcome was uneventful, with a stable correction after 44 months of follow-up. To our knowledge, this is the first repair of a quadricuspid pulmonary valve, through tricuspidisation.
authors.affiliation: Department of Cardiac Surgery, Prof. Dr. C.C. Iliescu Institute for Cardiovascular Disease, Bucharest, Romania. iosifescuag@yahoo.com
authors.forename: Andrei George
authors.initials: AG
authors.lastname: Iosifescu
authors.forename: Lucian Florin
authors.initials: LF
authors.lastname: Dorobantu
authors.forename: Traian Mihai
authors.initials: TM
authors.lastname: Anca
authors.forename: Vlad Anton
authors.initials: VA
authors.lastname: Iliescu
mesh_terms: D000293:Adolescent; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D058385:Cardiac Valve Annuloplasty; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011664:Pulmonary Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures