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Quadricuspid aortic valve (QAV) is a rare congenital valve defect. A comprehensive review in 2004 identified 186 cases in the literature.1 Echocardiographic appearances are pathognomonic and the natural history often reflects slowly progressive aortic regurgitation. QAV is typed according to the size of the four cusps.
Less well known is QAV's association with coronary anomalies in 10.2% of cases.1 Cases with a single coronary …