Prominent Eustachian Valve Mimicking Inferior Rim of Atrial Septum Causing Iatrogenic Inferior Vena Cava Type Sinus Venosus Atrial Septal Defect

Wang, Annie T; Kim, Uoo

doi:10.7759/cureus.15387

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…They found that approximately 65% of patients had significant improvement in oxygen saturation after the closure procedure, with some patients even having complete resolution of their dyspnea and hypoxemia. Patients with no signs of improvement following PFO closure were identified to have a pulmonary cause underlying their hypoxia [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Platypnea Orthodeoxia Syndrome Secondary to a Persistent Eustachian Valve

Rao¹,

Undavalli²,

Ghoweba³

et al. 2023

Cureus

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Platypnea-Orthodeoxia syndrome (POS) is a rare and poorly understood syndrome characterized by platypnea and oxygen desaturation in the upright position that is relieved by recumbency. Here, we report a case of an 84-year-old woman who had chronic hypoxia in an upright position despite using home oxygen. The patient presented for hypoxia evaluation and was noted to have a restrictive pattern on pulmonary function tests (PFT). An echocardiogram showed a prominent eustachian valve extending from inferior to superior vena cava with contrast approaching the interatrial septum. The patient had a complete resolution of her platypnea following the closure of the patent foramen ovale.

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Section: Discussionmentioning

confidence: 99%

Platypnea Orthodeoxia Syndrome Secondary to a Persistent Eustachian Valve

Rao¹,

Undavalli²,

Ghoweba³

et al. 2023

Cureus

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“…The predefined fluoroscopic end position in the aorta was at the level of the diaphragm with 2/3 of the balloon above the diaphragm and 1/3 below. The predefined fluoroscopic end position of the suprahepatic inferior vena cava balloon was at the level of the most cranially located hepatic vein, caudal to the right atrium and, when visible, the eustachian valve, ‘the valve of the inferior vena cava’ 26. Three persons performed all the procedures and measurements.…”

Section: Methodsmentioning

confidence: 99%

“…The predefined fluoroscopic end position of the suprahepatic inferior vena cava balloon was at the level of the most cranially located hepatic vein, caudal to the right atrium and, when visible, the eustachian valve, ‘the valve of the inferior vena cava’. 26 Three persons performed all the procedures and measurements. One person measured the time, the second performed the ultrasound exam and the third positioned the endovascular balloons.…”

Section: Methodsmentioning

confidence: 99%

A porcine study of ultrasound-guided versus fluoroscopy-guided placement of endovascular balloons in the inferior vena cava (REBOVC) and the aorta (REBOA)

Wikström

Åström

Hurtsén

et al. 2023

Trauma Surg Acute Care Open

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ObjectivesIn fluoroscopy-free settings, alternative safe and quick methods for placing resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative endovascular balloon occlusion of the inferior vena cava (REBOVC) are needed. Ultrasound is being increasingly used to guide the placement of REBOA in the absence of fluoroscopy. Our hypothesis was that ultrasound could be used to adequately visualize the suprahepatic vena cava and guide REBOVC positioning, without significant time-delay, when compared with fluoroscopic guidance, and compared with the corresponding REBOA placement.MethodsNine anesthetized pigs were used to compare ultrasound-guided placement of supraceliac REBOA and suprahepatic REBOVC with corresponding fluoroscopic guidance, in terms of correct placement and speed. Accuracy was controlled by fluoroscopy. Four intervention groups: (1) fluoroscopy REBOA, (2) fluoroscopy REBOVC, (3) ultrasound REBOA and (4) ultrasound REBOVC. The aim was to carry out the four interventions in all animals. Randomization was performed to either fluoroscopic or ultrasound guidance being used first. The time required to position the balloons in the supraceliac aorta or in the suprahepatic inferior vena cava was recorded and compared between the four intervention groups.ResultsUltrasound-guided REBOA and REBOVC placement was completed in eight animals, respectively. All eight had correctly positioned REBOA and REBOVC on fluoroscopic verification. Fluoroscopy-guided REBOA placement was slightly faster (median 14 s, IQR 13–17 s) than ultrasound-guided REBOA (median 22 s, IQR 21–25 s, p=0.024). The corresponding comparisons of the REBOVC groups were not statistically significant, with fluoroscopy-guided REBOVC taking 19 s, median (IQR 11–22 s) and ultrasound-guided REBOVC taking 28 s, median (IQR 20–34 s, p=0.19).ConclusionUltrasound adequately and quickly guide the placement of supraceliac REBOA and suprahepatic REBOVC in a porcine laboratory model, however, safety issues must be considered before use in trauma patients.Level of evidenceProspective, experimental, animal study. Basic science study.

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Clinical anatomy of the coronary venous system and relevance to retrograde cardioplegia and cardiac electrophysiological interventions

Kesieme,

Buchan

2024

Clinical Anatomy

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Anomalies of coronary venous system, the valve of the coronary sinus (Thebesian valve) and other cardiac malformations may make interventions through the coronary sinus difficult. These variants may pose a challenge in cannulating the coronary sinus for retrograde cardioplegia and for interventions performed through the coronary sinus by cardiac electrophysiologist/interventional cardiologist. Retrograde cardioplegia is an established method of myocardial protection with advantages, indications, and complications. A good knowledge of the anatomy of the coronary sinus and its variants is important in understanding the difficulties encountered while cannulating the coronary sinus for the delivery of retrograde cardioplegia, cardiac resynchronization therapy, treatment of arrhythmias, and percutaneous mitral valve annuloplasty.

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Prominent Eustachian Valve Mimicking Inferior Rim of Atrial Septum Causing Iatrogenic Inferior Vena Cava Type Sinus Venosus Atrial Septal Defect

Cited by 3 publications

References 9 publications

Platypnea Orthodeoxia Syndrome Secondary to a Persistent Eustachian Valve

Platypnea Orthodeoxia Syndrome Secondary to a Persistent Eustachian Valve

A porcine study of ultrasound-guided versus fluoroscopy-guided placement of endovascular balloons in the inferior vena cava (REBOVC) and the aorta (REBOA)

Clinical anatomy of the coronary venous system and relevance to retrograde cardioplegia and cardiac electrophysiological interventions

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