{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:16:26Z","timestamp":1757621786488,"version":"3.44.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Congenital heart disease (CHD) is a significant health concern affecting approximately 1% of live births. Among these anomalies, bicuspid aortic valve (BAV) is the most prevalent, while bicuspid pulmonary valve (BPV) remains exceptionally rare. This case report presents a unique instance of a 10-year-old girl diagnosed with the combination of BAV and BPV alongside a ventricular septal defect (VSD) and infundibular stenosis, referred to as the Gasul phenomenon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>The patient, initially identified with a heart murmur during infancy, exhibited dyspnea classified as New York Heart Association (NYHA) class II but showed no cyanosis or other acute symptoms. Echocardiographic evaluation revealed a small restrictive VSD with significant left-to-right shunting, severe infundibular stenosis, and the coexistence of both BAV and BPV. Surgical intervention involved closing the VSD and resecting the hypertrophied infundibular muscle, leading to improved hemodynamics and symptomatic relief postoperatively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This case emphasizes the rarity and complexity of having both bicuspid valves in a single patient and the clinical challenges associated with the Gasul phenomenon. It highlights the importance of comprehensive echocardiographic assessment and timely surgical intervention in managing such congenital anomalies, ultimately improving long-term outcomes. The report contributes to the limited literature on simultaneous BAV and BPV diagnoses and underscores the need for heightened clinical awareness and diagnostic scrutiny in pediatric patients with congenital heart defects. Further studies are warranted to explore the natural history and management strategies for patients with this unusual combination of cardiac anomalies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s43044-025-00682-8","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T15:46:18Z","timestamp":1757346378000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bicuspid pulmonary and bicuspid aortic valve in association with Gasul phenomenon (triple combination): a case report and literature review"],"prefix":"10.1186","volume":"77","author":[{"given":"Uma Devi","family":"Karuru","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Naveen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai Kumar","family":"Mysore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadanand Reddy","family":"Tummala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashirbad","family":"Parhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran Kumar","family":"Kanjerla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"682_CR1","first-page":"169","volume-title":"Valvular heart disease: a companion to Braunwald\u2019s heart disease","author":"C Otto","year":"2009","unstructured":"Otto C, Bonow R (2009) Valvular heart disease: a companion to Braunwald\u2019s heart disease. Saunders, Philadelphia, p 169"},{"key":"682_CR2","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.ahj.2004.10.036","volume":"150","author":"E Tutar","year":"2005","unstructured":"Tutar E, Ekici F, Atalay S et al (2005) The prevalence of bicuspid aortic valve in newborns by echocardiographic screening. Am Heart J 150:513\u2013515","journal-title":"Am Heart J"},{"key":"682_CR3","volume-title":"Heart disease in infancy and childhood","author":"J Keith","year":"1978","unstructured":"Keith J, Rowe R, Vlad P (1978) Heart disease in infancy and childhood. Macmillan Pub Co, New York"},{"issue":"8","key":"682_CR4","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1001\/jama.1957.02980080017003","volume":"64","author":"BM Gasul","year":"1957","unstructured":"Gasul BM, Dillon RF, Vrla V, Hait G (1957) Ventricular septal defects: their natural transformation into those with infundibular stenosis or into the cyanotic or noncyanotic type of tetralogy of Fallot. JAMA 64(8):847\u2013853","journal-title":"JAMA"},{"issue":"4","key":"682_CR5","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1007\/s00246-018-1807-x","volume":"39","author":"WMC Koenraadt","year":"2018","unstructured":"Koenraadt WMC, Bartelings MM, Gittenberger-de Groot AC et al (2018) Pulmonary valve morphology in patients with bicuspid aortic valves. Pediatr Cardiol 39(4):690\u2013694","journal-title":"Pediatr Cardiol"},{"issue":"2","key":"682_CR6","first-page":"67","volume":"5","author":"A Gupta","year":"2021","unstructured":"Gupta A, Tomar M, Tomar HS (2021) Coexistence of bicuspid aortic and pulmonary valve in patients with normally related great vessels: our experience. IHJ Cardiovasc Case Rep (CVCR) 5(2):67\u201370","journal-title":"IHJ Cardiovasc Case Rep (CVCR)"},{"issue":"2","key":"682_CR7","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1111\/echo.12517","volume":"31","author":"T Kemalo\u011flu \u00d6z","year":"2014","unstructured":"Kemalo\u011flu \u00d6z T, Karadeniz F\u00d6, Gundlapalli H et al (2014) Coexisting bicuspid aortic and pulmonary valves with normally related great vessels diagnosed by live\/real time three-dimensional transoesophageal echocardiography. Echocardiography 31(2):218\u2013221","journal-title":"Echocardiography"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00682-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-025-00682-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00682-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T15:46:19Z","timestamp":1757346379000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-025-00682-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["682"],"URL":"https:\/\/doi.org\/10.1186\/s43044-025-00682-8","relation":{},"ISSN":["2090-911X"],"issn-type":[{"type":"electronic","value":"2090-911X"}],"subject":[],"published":{"date-parts":[[2025,9,8]]},"assertion":[{"value":"19 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written and informed consent was obtained from the parents of the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"85"}}