Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T06:32:07.006Z Has data issue: false hasContentIssue false

Echocardiography of the prominent Eustachian valve—associations and complications with cyanosis and right heart obstruction

Published online by Cambridge University Press:  19 August 2008

Michael M. Brook*
Affiliation:
From the Departments of Pediatrics, Division of Pediatric Cardiology, University of California, San Francisco
Norman H. Silverman
Affiliation:
From the Departments of Pediatrics, Division of Pediatric Cardiology, University of California, San Francisco
*
Dr. Michael M. Brook, University of California, San Francisco, Pediatric Echocardiography Laboratory, 505 Parnassus Ave., Room M342A, Box 0214, San Francisco, CA 94143-0214, USA. Tel.415-476-5887; Fax. 415-476-5875.

Summary

We reviewed the echocardiographic features of 16 children with prominent Eustachian valves, six of whom had associated pathology of the right heart, while eight had other anomalies, primarily atrial and ventricular septal defects. The hearts of two patients were structurally normal. Prolapse of the membrane through the orifice of the tricuspid valve or through the atrial septum was present in seven patients, two of whom were symptomatic. One presented with severe cyanosis which resolved after surgical removal on the basis of the echocardiographic findings. The other presented with atrial arrhythmias which did not improve with removal. The size or behavior of the membrane, including prolapse, did not correlate with either age or presence of pathology of the right heart. The echocardiographic appearance of prominent Eustachian valves is variable. Rarely, when prominent, the valves can cause symptoms associated with obstruction to the right heart, particularly cyanosis or an arrhythmia.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Yater, WM. Variations and anomalies of the venous valves of the right atrium ofthe human heart. Arch Pathol 1929; 7:418441.Google Scholar
2.Werner, JACheitlin, MDGross, BWSpeck, SMIvey, TD. Echocardiographic appearance of the Chiari network: differ entiation from right–heart pathology. Circulation 1981; 63:11041109.CrossRefGoogle Scholar
3.Trento, AZuberbuhler, JRAnderson, RHPark, SCSiewers, RD. Divided right atrium (prominence of the Eustachian and Thebesian valves). J Thorac Cardiovasc Surg 1988; 96: 457463.CrossRefGoogle ScholarPubMed
4.Burton, DAChin, AWeinberg, PMPigott, JD. Identification ofcor triatriatum dexter by two-dimensional echocardiography. Am J Cardiol 1987; 60: 409410.CrossRefGoogle Scholar
5.Mazzucco, ABortolotti, UDel, TSPeliegrino, P. Successful repair of symptomatic cor triatriatum dexter in infancy. J Thorac Cardiovasc Surg 1983; 85: 140143.CrossRefGoogle ScholarPubMed
6.Alboliras, ETEdwards, WDDriscoll, DJSeward, JB. Cor triatriatum dexter: two-dimensional echocardiographic diag nosis. JAm Coil Cardiol 1987; 9: 334337.CrossRefGoogle Scholar
7.Ott, DAColley, DAAngelinie, PLeachman, RD. Successful surgical correction of symptomatic cor triatriatum dexter. J Thorac Cardiovasc Surg 1979; 78: 573575.CrossRefGoogle ScholarPubMed
8.Clements, JSobotka-Plojhar, MExako, NVanGeijn, HP. A connective tissue membrane in the right atrium (Chiari's network) as a cause of a fetal cardiac arrhythmia. AmJ Obstet Gynecol 1982; 142: 709712.CrossRefGoogle ScholarPubMed
9.Kilman, JWWilliams, TEKakos, GSMolnar, WRyan, JM. Budd-Chiari syndrome due to congenital obstruction of the Eustachian valve ofthe inferior caval vein. J Thorac Cardiovasc Surg 1971; 62: 226230.CrossRefGoogle Scholar
10.Limacher, MCGutgesell, HPVick, GWCohen, MHHuhta, JH. Echocardiographic anatomy of the Eustachian valve. Am J Cardiol 1986; 57: 363365.CrossRefGoogle ScholarPubMed
11.Van Hare, GFSilverman, NH. Contrast two-dimensional echocardiography in congenital heart disease: techniques, indications and clinical utility. J Am Coil Cardiol 1989; 13:673686.CrossRefGoogle ScholarPubMed
12.Jones, RNNiles, NR. Spinnaker formation of sinus venosus valve. Circulation 1968; 38: 468473.CrossRefGoogle ScholarPubMed
13.Doucette, JKnoblich, R. Persistent right valve of the sinus venosus: so-called cor triatriatum dextrum: review of the literature and report ofa case. Arch Pathol 1963; 75: 105112.Google Scholar