array:25 [
  "pii" => "S2174204916302380"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.11.007"
  "estado" => "S300"
  "fechaPublicacion" => "2016-12-01"
  "aid" => "902"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Rev Port Cardiol. 2016;35:707-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1792
    "formatos" => array:3 [
      "EPUB" => 140
      "HTML" => 1259
      "PDF" => 393
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0870255116302694"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2015.12.013"
      "estado" => "S300"
      "fechaPublicacion" => "2016-12-01"
      "aid" => "902"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "sco"
      "cita" => "Rev Port Cardiol. 2016;35:707-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2159
        "formatos" => array:3 [
          "EPUB" => 192
          "HTML" => 1548
          "PDF" => 419
        ]
      ]
      "en" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
        "titulo" => "Unexpected diagnosis in a liver donor candidate"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "707"
            "paginaFinal" => "708"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Diagn&#243;stico inesperado num candidato a dador de f&#237;gado"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1045
                "Ancho" => 1586
                "Tamanyo" => 143553
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography&#44; short-axis view during systole&#44; showing quadricuspid aortic valve&#46; AV&#58; aortic valve&#59; LA&#58; left atrium&#59; RA&#58; right atrium&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Betul Cengiz, Sukru Taylan Sahin, Selen Yurdakul, Ismail Polat Canbolat, Saide Aytekin"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Betul"
                "apellidos" => "Cengiz"
              ]
              1 => array:2 [
                "nombre" => "Sukru Taylan"
                "apellidos" => "Sahin"
              ]
              2 => array:2 [
                "nombre" => "Selen"
                "apellidos" => "Yurdakul"
              ]
              3 => array:2 [
                "nombre" => "Ismail Polat"
                "apellidos" => "Canbolat"
              ]
              4 => array:2 [
                "nombre" => "Saide"
                "apellidos" => "Aytekin"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204916302380"
          "doi" => "10.1016/j.repce.2016.11.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302380?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302694?idApp=UINPBA00004E"
      "url" => "/08702551/0000003500000012/v2_201701270020/S0870255116302694/v2_201701270020/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204916302409"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.11.009"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "905"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2016;35:709-10"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1745
      "formatos" => array:3 [
        "EPUB" => 147
        "HTML" => 1260
        "PDF" => 338
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "Amorphous tumor of the mitral valve"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "709"
          "paginaFinal" => "710"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Tumor amorfo da v&#225;lvula mitral"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0020"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 748
              "Ancho" => 701
              "Tamanyo" => 126247
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Histology showing dystrophic calcifications and fibrosis&#44; with no other changes and no evidence of inflammation or tumor&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Henrique Guedes, Nuno Moreno, Rui Cunha Sousa, M&#225;rio Jorge Amorim, Aurora Andrade, Paula Pinto"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Henrique"
              "apellidos" => "Guedes"
            ]
            1 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Moreno"
            ]
            2 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Cunha Sousa"
            ]
            3 => array:2 [
              "nombre" => "M&#225;rio Jorge"
              "apellidos" => "Amorim"
            ]
            4 => array:2 [
              "nombre" => "Aurora"
              "apellidos" => "Andrade"
            ]
            5 => array:2 [
              "nombre" => "Paula"
              "apellidos" => "Pinto"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116302724"
        "doi" => "10.1016/j.repc.2016.01.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302724?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302409?idApp=UINPBA00004E"
    "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302409/v2_201702040044/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2174204916302392"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.11.008"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "904"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2016;35:703-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1785
      "formatos" => array:3 [
        "EPUB" => 150
        "HTML" => 1264
        "PDF" => 371
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "Segmental pulmonary stenosis&#58; Importance of computed tomography angiography"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "703"
          "paginaFinal" => "705"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Estenose pulmonar multisegmentar&#44; import&#226;ncia da angio TC"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1998
              "Ancho" => 2000
              "Tamanyo" => 536138
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Severe stenosis at the origin of most of the lobar pulmonary arteries and diffuse stenosis of the rest &#40;A-D&#41;&#44; and underdevelopment of the aortic arch &#40;E&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Santiago Colunga Blanco, Isaac Mart&#237;nez Benday&#225;n, Maria Jos&#233; Mart&#237;nez Sapi&#241;a Llanas, Beatriz Bouzas Zubeldia, Fernando Rueda Nu&#241;ez, Jos&#233; Manuel V&#225;zquez Rodr&#237;guez"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Colunga Blanco"
            ]
            1 => array:2 [
              "nombre" => "Isaac"
              "apellidos" => "Mart&#237;nez Benday&#225;n"
            ]
            2 => array:2 [
              "nombre" => "Maria Jos&#233;"
              "apellidos" => "Mart&#237;nez Sapi&#241;a Llanas"
            ]
            3 => array:2 [
              "nombre" => "Beatriz"
              "apellidos" => "Bouzas Zubeldia"
            ]
            4 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Rueda Nu&#241;ez"
            ]
            5 => array:2 [
              "nombre" => "Jos&#233; Manuel"
              "apellidos" => "V&#225;zquez Rodr&#237;guez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116302712"
        "doi" => "10.1016/j.repc.2015.12.014"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302712?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302392?idApp=UINPBA00004E"
    "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302392/v2_201702040044/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
    "titulo" => "Unexpected diagnosis in a liver donor candidate"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "707"
        "paginaFinal" => "708"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Betul Cengiz, Sukru Taylan Sahin, Selen Yurdakul, Ismail Polat Canbolat, Saide Aytekin"
        "autores" => array:5 [
          0 => array:3 [
            "nombre" => "Betul"
            "apellidos" => "Cengiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Sukru Taylan"
            "apellidos" => "Sahin"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Selen"
            "apellidos" => "Yurdakul"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ismail Polat"
            "apellidos" => "Canbolat"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:4 [
            "nombre" => "Saide"
            "apellidos" => "Aytekin"
            "email" => array:1 [
              0 => "saideaytekin&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Department of Cardiology&#44; Istanbul Bilim University&#44; Istanbul&#44; Turkey"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Cardiology&#44; Florence Nightingale Hospital&#44; Istanbul&#44; Turkey"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Diagn&#243;stico inesperado num candidato a dador de f&#237;gado"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 628
            "Ancho" => 951
            "Tamanyo" => 91873
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography&#44; short-axis view during systole&#44; showing quadricuspid aortic valve&#46; AV&#58; aortic valve&#59; LA&#58; left atrium&#59; RA&#58; right atrium&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Liver transplantation from living donors is a legal procedure in Turkey&#46; The patient&#39;s spouse and relatives within the fourth degree of consanguinity or affinity can be donors&#46; During the surgery&#44; about 40-60&#37; of the donor&#39;s liver is removed&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 38-year-old female liver donor candidate was referred to our cardiology clinic for preoperative evaluation&#46; The patient had no symptoms&#46; On physical examination&#44; a grade 2&#47;6 early diastolic murmur was heard at the third left sternal intercostal space&#46; Her blood pressure was 140&#47;70 mmHg&#46; Transthoracic echocardiography revealed moderate aortic regurgitation &#40;AR&#41; with the suspicion of quadricuspid aortic valve &#40;QAV&#41;&#46; Left ventricular end-diastolic and end-systolic diameters were 5&#46;6 cm and 4&#46;0 cm&#44; respectively&#46; Ejection fraction was normal&#46; Transesophageal echocardiography confirmed the diagnosis of QAV with four equal cusps &#40;Type A&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>&#44; <a class="elsevierStyleCrossRef" href="#sec0040">Video 1</a>&#41; with moderate AR &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; The patient was removed from the donor list with a suggestion for regular outpatient cardiology clinic visits&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Quadricuspid aortic valve is a rare congenital cardiac anomaly that is mostly diagnosed incidentally&#46; AR usually develops due to fibrosis and incomplete coaptation of the leaflets caused by unequal shear stress&#46; Stenosis can occur but is rare&#46; The risk of infective endocarditis is unknown but there have been documented cases in the literature&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Consequently&#44; if there is unexplained AR&#44; congenital valve anomalies including QAV should be considered as a possible cause&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflicts of interest"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-11-08"
    "fechaAceptado" => "2015-12-08"
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0050" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0040"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 628
            "Ancho" => 951
            "Tamanyo" => 91873
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography&#44; short-axis view during systole&#44; showing quadricuspid aortic valve&#46; AV&#58; aortic valve&#59; LA&#58; left atrium&#59; RA&#58; right atrium&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 633
            "Ancho" => 958
            "Tamanyo" => 82277
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography&#44; short-axis view at end-systole&#44; showing quadricuspid aortic valve&#46; AV&#58; aortic valve&#59; LA&#58; left atrium&#59; RA&#58; right atrium&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 637
            "Ancho" => 958
            "Tamanyo" => 114146
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography&#44; long-axis view during diastole&#44; showing aortic regurgitation&#46; AR&#58; aortic regurgitation&#59; Ao&#58; aortic valve&#59; LA&#58; left atrium&#59; LV&#58; left ventricle&#46;</p>"
        ]
      ]
      3 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc1.mp4"
          "ficheroTamanyo" => 698472
          "Video" => array:2 [
            "mp4" => array:2 [
              "fichero" => "mmc1.m4v"
              "poster" => "mmc1.jpg"
            ]
            "flv" => array:5 [
              "fichero" => "mmc1.flv"
              "poster" => "mmc1.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302380/v2_201702040044/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9915"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Images in cardiology"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000012/v2_201702040044/S2174204916302380/v2_201702040044/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302380?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 35. Issue 12.
Pages 707-708 (December 2016)
Share
Share
Download PDF
More article options
Vol. 35. Issue 12.
Pages 707-708 (December 2016)
Image in Cardiology
Open Access
Unexpected diagnosis in a liver donor candidate
Diagnóstico inesperado num candidato a dador de fígado
Visits
4715
Betul Cengiza, Sukru Taylan Sahina, Selen Yurdakula, Ismail Polat Canbolata, Saide Aytekinb,
Corresponding author
saideaytekin@gmail.com

Corresponding author.
a Department of Cardiology, Istanbul Bilim University, Istanbul, Turkey
b Department of Cardiology, Florence Nightingale Hospital, Istanbul, Turkey
This item has received

Under a Creative Commons license
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Additional material (1)
Full Text

Liver transplantation from living donors is a legal procedure in Turkey. The patient's spouse and relatives within the fourth degree of consanguinity or affinity can be donors. During the surgery, about 40-60% of the donor's liver is removed.

A 38-year-old female liver donor candidate was referred to our cardiology clinic for preoperative evaluation. The patient had no symptoms. On physical examination, a grade 2/6 early diastolic murmur was heard at the third left sternal intercostal space. Her blood pressure was 140/70 mmHg. Transthoracic echocardiography revealed moderate aortic regurgitation (AR) with the suspicion of quadricuspid aortic valve (QAV). Left ventricular end-diastolic and end-systolic diameters were 5.6 cm and 4.0 cm, respectively. Ejection fraction was normal. Transesophageal echocardiography confirmed the diagnosis of QAV with four equal cusps (Type A) (Figures 1 and 2, Video 1) with moderate AR (Figure 3). The patient was removed from the donor list with a suggestion for regular outpatient cardiology clinic visits.

Figure 1.

Transesophageal echocardiography, short-axis view during systole, showing quadricuspid aortic valve. AV: aortic valve; LA: left atrium; RA: right atrium.

(0.09MB).
Figure 2.

Transesophageal echocardiography, short-axis view at end-systole, showing quadricuspid aortic valve. AV: aortic valve; LA: left atrium; RA: right atrium.

(0.08MB).
Figure 3.

Transesophageal echocardiography, long-axis view during diastole, showing aortic regurgitation. AR: aortic regurgitation; Ao: aortic valve; LA: left atrium; LV: left ventricle.

(0.11MB).

Quadricuspid aortic valve is a rare congenital cardiac anomaly that is mostly diagnosed incidentally. AR usually develops due to fibrosis and incomplete coaptation of the leaflets caused by unequal shear stress. Stenosis can occur but is rare. The risk of infective endocarditis is unknown but there have been documented cases in the literature.

Consequently, if there is unexplained AR, congenital valve anomalies including QAV should be considered as a possible cause.

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2016. Sociedade Portuguesa de Cardiologia
Download PDF
Idiomas
Revista Portuguesa de Cardiologia (English edition)
Article options
Tools
Supplemental materials
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.