Severe Aortic Regurgitation Caused by Congenital Quadricuspid Aortic Valve With an Anomalous Cord

Summary An aortic valve in a 71-year-old female exhibited a quadricuspid valve morphology. Two-dimensional transesophageal echocardiography showed an incompletely separated non-coronary cusp and severe aortic regurgitation. Moreover, real time three-dimensional transesophageal echocardiography indicated the presence of an anomalous cord that appeared to be adhered to the tip of the two leaflets of the incompletely separated non-coronary cusp.