A 54 year old female presented with lower extremity edema, fatigue, and shortness of breath with physical findings indicative of advanced aortic insufficiency.Echocardiography showed severe aortic regurgitation and a probable quadricuspid aortic chalk older valve.In anticipation of aortic valve replacement, cardiac computed tomography (Cardiac CT) was performed using 100 kV, 420 mA which resulted in 6 mSv of radiation exposure.Advanced computing algorithmic software was performed with a non-linear interpolation to estimate potential physiological movement.
Surgical photographs and in-vitro anatomic pathology exam reveal the accuracy and precision that preoperative Cardiac CT provided in this rare case of a quadricuspid aortic valve.While there have been isolated reports of quadricuspid diagnosis with Cardiac CT, we report the correlation between echocardiography, Cardiac CT, T-Shirts and similar appearance at surgery with confirmed pathology and interesting post-processed rendered images.Cardiac CT may be an alternative to invasive coronary angiography for non-coronary cardiothoracic surgery with the advantage of providing detailed morphological dynamic imaging and the ability to define the coronary arteries non-invasively.The reduced noise and striking depiction of the valve motion with advanced algorithms will require validation studies to determine its role.