Two cases of quadricuspid aortic valve

Quadricuspid aortic valve (QAV) is a rare congenital aortic valve anomaly. We present two cases of QAV diagnosed by using echocardiography including transesophageal echocardiography (TEE) and cardiac computed tomography (CT). The first case, QAV with four equal-sized cusps, was identified in a 58-year-old man. The second case, QAV with a small accessory cusp between the right coronary and non-coronary cusp, was identified in a 42-year-old man. TEE and cardiac CT could lead to accurate diagnosis of QAV. QAV in these two patients could be diagnosed before indication for surgery but it is necessary to continue careful follow-up.