Giant Chiari Network, Foramen Ovale, and Paradoxical Embolism

Impending Paradoxical Embolism

“…The therapeutic treatment of IPDE is still controversial. Treatment options vary from anticoagulation alone to more aggressive strategies, including fibrinolytic regimens or cardiac surgical procedure [1][2][3]. Herein, we report 2 cases who presented with a very large impending paradoxical embolus and were successfully diagnosed and treated with cardiac surgical procedure or fibrinolytic regimens.…”

A case of Chiari network and paradoxical emboli

“…Despite the fact that in itself is not important, but its presence is associated with a great range of symptoms. Several disturbances such as PFO, paradoxical emboli, clot formation, infective endocarditis, heart failure, and supraventricular arrhythmia are reported [5,[8][9][10][11]. Also preventing from right atrium catheter implantation, pace wire lead insertion and CPB cannulation are related to Chiari network [12][13][14].…”

“…Simultaneous PFO is reported in more than 80% of patients [11]. In the presence of PFO the risk of paradoxical emboli and ischemic stroke is increased [18].…”

Anatomical Study of Chiari Network and the Remnant of Left Venous Valve in the Interior of Right Atrium

“…This favors the persistence of patent foramen ovale thus creating cyanosis [ 1 ], atrial septal aneurysm, and paradoxical embolism from right to left atrium resulting to thromboembolic manifestations [ 3 ]. The network is associated with patent foramen ovale in 80% of cases [ 11 ]. However, in the present study Chiari network was not associated with patent foramen ovale.…”

“…In spite of its benign nature, Chiari network can be associated with infective endocarditis [ 17 , 18 ], tricuspid atresia [ 19 ], fibroelastic papilloma [ 20 ], fetal hydrops [ 21 ], atrial septal aneurysm [ 1 ], atrial fibrillation [ 2 ], paradoxical embolism [ 11 ], Behcet's disease [ 22 ], and platypnea-orthodeoxia with atrial septal hypertrophy [ 23 ]. It may create an additional heart sound.…”