The role of eustachian valve and patent foramen ovale in sudden death

Aşırdizer, Mahmut; Tatlısumak, Ertuğrul

doi:10.1016/j.jcfm.2005.11.009

Cited by 6 publications

(3 citation statements)

References 65 publications

(57 reference statements)

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“…The average length of the EV was reported to be 3.6 mm, with a range of 1.5-23 mm. 4,5) It may persist as a mobile elongated structure, like in our case, extending into the right atrium. It may thus be mistaken for an abnormal cardiac mass and should be differentiated from atrial tumors, thrombi or vegetations.…”

Section: Discussionmentioning

confidence: 58%

Unusual Elongation of the Eustachian Valve

2007

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SUMMARYWe report a patient with a snake-shaped, mobile mass in the right atrium. The mass was determined to be an elongated Eustachian valve which was a persistent part of the embryologic valve of the sinus venosus. (Int Heart J 2007; 48: 113-116) Key words: Eustachian valve, Right atrium, Mass IN fetal life, the direction of oxygen-rich blood from the inferior vena cava into the systemic circulation through the foramen ovale is controlled by the Eustachian valve (EV).1) After birth, it may disappear or may be seen in echocardiographic examinations as a nonfunctional, thin, filamentous structure originating from the orifice of the inferior vena cava.2) Here we report an unusually elongated EV in a 20-year-old man. CASE REPORTA 20-year-old man was admitted to our hospital due to mild dyspnea and fatigue on exertion. There were no specific findings in his medical history. At admission, the systolic blood pressure was 120 mmHg, diastolic blood pressure 70 mmHg, pulse rate 90/minute, respiration rate 20/minute, and body temperature 37.0°C. A physical examination was normal. The cardiothoracic ratio was within normal limits in teleradiography. Normal sinus rhythm was present in an electrocardiographic examination. Routine blood tests were normal. Transthoracic echocardiography (TTE) was performed in an attempt to explain the etiology of the dyspnea. Left ventricular (LV) wall thickness, LV systolic and diastolic dimensions, and LV ejection fraction were normal. There were no abnormalities in the valvular structures. Systolic pulmonary artery pressure was normal. However, a snake-shaped, thin, linear and mobile mass (about 35 mm in length) was seen in the right atrium on apical 4-chamber view (Figure 1). One edge of the mass was attached to the wall of the right atrium and the other edge was free. The structure was not obstructing transtricuspid blood flow. When transesophageal From the

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Section: Discussionmentioning

confidence: 58%

Unusual Elongation of the Eustachian Valve

2007

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“…[8910] Moreover, it has been demonstrated that a redundant Eustachian valve could interfere with the placement of a PFO occluder, and this may influence the choice of treatment (medical or surgical). [1112]…”

Section: Case Historymentioning

confidence: 99%

Transesophageal contrast echocardiography is not always the gold standard method in the identification of a patent foramen ovale: A clinical case

Lunetta

Costa

Gattuta

et al. 2015

J Cardiovasc Echography

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In the embryo, Eustachian valve is a crescent-shaped membrane extending from the lower margin of the inferior vena cava and the ostium of the coronary sinus into the right atrium toward fossa ovalis and tricuspid valve. At birth, after the functional closure of the foramen ovale, the Eustachian valve loses its function, reducing to an embryo remnant.According to growing evidence, a persistent Eustachian valve is a frequent finding in patients with a patent foramen ovale (PFO). By directing the blood from the inferior cava to the interatrial septum, it may prevent the spontaneous closure of PFO after birth and indirectly predispose to paradoxical embolism.Transesophageal contrast enhanced echocardiography (cTEE) is considered the gold standard to diagnose a PFO in postnatal life, but its accuracy maybe is not so high in the presence of a persistent Eustachian valve.In these cases, color Doppler TEE is more sensitive and simplifies the diagnostic process, reducing the duration of TEE and improving the patient compliance.

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“…PFO has also been identified as a potential culprit or confounding factor for a variety of other disease states, including plathypnea-orthodeoxia [72], decompression illness in divers [73,74], obstructive sleep apnea syndrome [75][76][77][78][79], cerebral damage in Alzheimer's disease [80], transient global amnesia [81], sudden death [82], hypoxemia in high-altitude pulmonary edema [83] and chronic obstructive pulmonary disease [84,85]. It has been implicated as a risk factor for stroke or TIA during pregnancy [86,87], neurosurgical operations with the patient in a sitting position [88] and fat embolism during orthopedic surgery [89], as well as a potential cause of dyspnea and hypoxemia after cardiothoracic surgery [90], and increased rates of atrial fibrillation following coronary artery bypass grafting [91].…”

Section: Left Atriummentioning

confidence: 99%

BioSTAR^®bioabsorbable septal repair implant

Mullen¹,

Devellian²,

Jux³

2007

Expert Review of Medical Devices

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Thousands of patients have had congenital defects of their intra-atrial septa successfully closed via percutaneous techniques in the cardiac catheterization laboratory for hemodynamic correction, stroke, migraine and decompression illness. However, currently available closure technologies leave a permanent cardiac implant in a relatively young patient population. As the first device incorporating a bioabsorbable material for the treatment of structural heart disease, BioSTAR is uniquely designed to remodel into native tissue following closure, providing a more natural method of defect repair. This paper reviews atrial morphology, with a focus on patent foramen ovale, indications both present and emerging, and the development of technologies that promote a healthy natural healing response, with a focus on the design, testing and clinical experience with BioSTAR.

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The role of eustachian valve and patent foramen ovale in sudden death

Cited by 6 publications

References 65 publications

Unusual Elongation of the Eustachian Valve

Unusual Elongation of the Eustachian Valve

Transesophageal contrast echocardiography is not always the gold standard method in the identification of a patent foramen ovale: A clinical case

BioSTAR^®bioabsorbable septal repair implant

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The role of eustachian valve and patent foramen ovale in sudden death

Cited by 6 publications

References 65 publications

Unusual Elongation of the Eustachian Valve

Unusual Elongation of the Eustachian Valve

Transesophageal contrast echocardiography is not always the gold standard method in the identification of a patent foramen ovale: A clinical case

BioSTAR®bioabsorbable septal repair implant

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Product

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BioSTAR^®bioabsorbable septal repair implant