title: Morphological and Functional Evaluation of Quadricuspid Aortic Valves Using Cardiac Computed Tomography.
abstract: The aim of this study was to identify the morphological and functional characteristics of quadricuspid aortic valves (QAV) on cardiac computed tomography (CCT).
  
  
  
  We retrospectively enrolled 11 patients with QAV. All patients underwent CCT and transthoracic echocardiography (TTE), and 7 patients underwent cardiovascular magnetic resonance (CMR). The presence and classification of QAV assessed by CCT was compared with that of TTE and intraoperative findings. The regurgitant orifice area (ROA) measured by CCT was compared with severity of aortic regurgitation (AR) by TTE and the regurgitant fraction (RF) by CMR.
  
  
  
  All of the patients had AR; 9 had pure AR, 1 had combined aortic stenosis and regurgitation, and 1 had combined subaortic stenosis and regurgitation. Two patients had a subaortic fibrotic membrane and 1 of them showed a subaortic stenosis. One QAV was misdiagnosed as tricuspid aortic valve on TTE. In accordance with the Hurwitz and Robert's classification, consensus was reached on the QAV classification between the CCT and TTE findings in 7 of 10 patients. The patients were classified as type A (n = 1), type B (n = 3), type C (n = 1), type D (n = 4), and type F (n = 2) on CCT. A very high correlation existed between ROA by CCT and RF by CMR (r = 0.99) but a good correlation existed between ROA by CCT and regurgitant severity by TTE (r = 0.62).
  
  
  
  Cardiac computed tomography provides comprehensive anatomical and functional information about the QAV.
authors.affiliation: Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Inyoung
authors.initials: I
authors.lastname: Song
authors.affiliation: Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jung Ah
authors.initials: JA
authors.lastname: Park
authors.affiliation: Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Bo Hwa
authors.initials: BH
authors.lastname: Choi
authors.affiliation: Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Ko
authors.affiliation: Department of Thoracic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Je Kyoun
authors.initials: JK
authors.lastname: Shin
authors.affiliation: Department of Thoracic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
authors.affiliation: Department of Thoracic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Aortic regurgitation; Aortic valve; Echocardiography; Magnetic resonance imaging; Multidetector computed tomography; Valvular heart disease, congenital