Each of these asymptomatic patients had both a QAV and MVP The occurrence of both these valvular anomalies in the same patient supports the observation that they are of congenital origin and may be associated.
The two most common types of QAV were Hurwitz and Roberts type A (four equally sized cusps) and type B (three larger equal cusps and one smaller cusp) (6).
Our review, however, demonstrated that no patients with a combined QAV and MVP required surgery of both valves.
In patients with QAV, the attention is usually focused on that valve in particular, and so the association with MVP may not have been as strongly linked.
Further, while the association of a QAV with hypertrophic obstructive cardiomyopathy may be rare (1) it is nonetheless often associated with other congenital heart defects.
Therefore, anyone who is not so familiar with this rare congenital heart defect should keep in mind that the most prevalent hemodynamic abnormality associated with a QAV is aortic regurgitation, often leading to aortic valve repair or replacement (3).
Hurwitz and Roberts (3) described seven different types of QAV depending on the size of the cusps.