山崎 忠男¹, 石光 敏行¹, 平沼 ゆり¹, 神谷 英樹¹, 榎本 強志¹, 芳賀 厚子¹, 杉下 靖郎¹, 稲葉 武², 出沢 文子², 寺田 康³, 三井 利夫³

Tadao YAMAZAKI¹, Toshiyuki ISHIMITSU¹, Yuri HIRANUMA¹, Hideki KAMIYA¹, Tsuyosi ENOMOTO¹, Atsuko YOSHIGA¹, Yasurou SUGISHITA¹, Takeshi INABA², Fumiko DEZAWA², Yasushi TERADA³, Toshio MITSUI³

¹筑波大学臨床医学系内科, ²筑波大学附属病院機能検査部, ³筑波大学臨床医学系外科

¹Department of Internal Medicine, Tsukuba University Institute of Clinical Medicine, ²Laboratory Section, Tsukuba University Institute of Clinical Medicine, ³Department of Surgery, Tsukuba University Institute of Clinical Medicine

キーワード : Aortic regurgitation, Aortic valve fenestrations, Infective endocarditis, Quadricuspid aortic valve, Transesophageal echocardiography

A 66-year-old man was admitted to this institution in February 1995 for evaluation of heart failure that occurred after he received a blood transfusion. A loud to-and-fro murmur was audible along the left sternal border. Hematocrit was 21.6%, CRP was elevated, and β-hemolytic streptococci was isolated in the blood culture. Transthoracic and transesophageal echocardiography showed aortic regurgitation and four cusps of equal size on the aortic valve with vegetation and fenestrations in the center of the right and noncoronary cusps, and these findings were visually confirmed on surgery. This is the first reported case of quadricuspid aortic valve associated with infective endocarditis that was diagnosed by echocardiography before surgery. Thirty-two other cases of quadricuspid aortic valve reported in Japan are also reviewed here.