Abstract
RATIONALE: Quadricuspid aortic valve (QAV) is a rare condition with a very low incidence. Anomalous aortic origin of a coronary artery (AAOCA) is the most prevalent form of coronary anomaly. One variant of AAOCA is the anomalous aortic origin of the left coronary artery from the right coronary sinus (L-AAOCA). It is even rarer for QAV to occur in combination with AAOCA. PATIENT CONCERNS: In this case report, we present a patient who was diagnosed with QAV and L-AAOCA using preoperative transesophageal echocardiography and 3-dimensional computed tomography (3D-CT). DIAGNOSES: Cardiac-enhanced CT showed an anomalous aortic origin of the left coronary artery from the right coronary sinus with an intramural course. INTERVENTIONS: The patient underwent sub-coronary ROSS procedure along with the unroofing procedure. OUTCOMES: The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD. LESSONS: The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.