Introduction: Quadricuspid Aortic Valve (QAV) is a rare congenital heart disease characterized by four leaflets that may be of identical or varying sizes. A less common scenario includes QAV accompanied by aortic valve stenosis. Diagnosing it is difficult, and it is seen more frequently in individuals with aortic insufficiency. It estimated incidence rate of this illness ranges from 0.013% to 0.043%. Babington first reported it in 1847, and since that time, around 300 cases have been published.
This condition is occasionally associated with other congenital cardiovascular defects, with coronary artery irregularities being the most frequent. In over fifty percent of published QAV incidences, it has led to the progressive development of aortic regurgitation (AR) usually sans aortic stenosis, particularly amongst the elderly patients, frequently necessitating surgical treatment after the age of 50 We report a case of severe aortic valve insufficiency, moderate aortic valve stenosis, left main, and three-vessel coronary artery disease, thus being a candidate for aortic valve replacement and coronary artery bypass graft surgery; the case was accidentally diagnosed with QAV during surgery.
