Large Eustachian valve: An incidental finding yet perplexing.

Eustachian valve (EV), a remnant of the right valve of sinus venosus in the right atrium can be puzzling. Often it is confused with Chiari network or atrial adhesions and is reported with unusual complications. We report a case of large EV impeding cannulation of inferior vena cava (IVC) during aortic valve replacement. Transesophageal echocardiography diagnosed the presence of large EV and warned of the difficulty with IVC cannulation and helped preparedness for an alternative plan during surgery.

Intracardiac Eustachian Valve Cyst in an Adult Detected with Other Cardiac Anomalies: Usefulness of Multidetector CT in Diagnosis

We present an unusual case of an intracardiac Eustachian valve cyst observed concurrently with atresia of the coronary sinus ostium, a persistent left superior vena cava (LSVC) and a bicuspid aortic valve. There have been several echocardiographic reports of Eustachian valve cysts; however, there is no report of multidetector computed tomography (MDCT) findings related to a Eustachian valve cyst. Recently, we observed a Eustachian valve cyst diagnosed on MDCT showing a hypodense cyst at the characteristic location of the Eustachian valve (the junction of the right atrium and inferior vena cava). MDCT also demonstrated additional cardiovascular anomalies including atresia of the coronary sinus ostium and a persistent LSVC and bicuspid aortic valve.

Pathologic and etiologic studies of membrane obstruction of the inferior vena cava in Budd-Chiari syndrome / 介入放射学杂志

Objective To study the anatomical location and pathology of membranous obstruction of the inferior vena cava(IVC)in Budd-Chiari syndrome(BCS)with research on the etiologic mechanism and pathology.Methods Analysis of 100 normal adults was performed including the gross anatomy of IVC segment from the level of diaphragm up to right atrium.The conventional,microscopic pathologic examination of the biopsy sampling IVC obstruetice mambrane tissue in 70 cases toghther with the complete resected membrane from the radical therapy for 20 cases of BCS,were collected and under investigation.Results The macroscopic examination revealed the obstructive membrane in one case(1%)localizing at the diaphragmatic level,approximately 28 mm,away from the IVC entrance into the right atrium and a newly found valvula was seen on the left lateral wall of the upper part of the hepatic vein orifice.Simultaneously,47% adults showed Eustachiun valve existing in IVC near the entrance to right atrium.Microscopy confirmed all the forementioned membranes consisting of vascular valvular structures.Among them(21/70),30% showed additional organized thrombus formations,and 9%(6/70)with a few amount of inflammatory cellular infiltrations.The total intact resection membrane was continuous with the vascular wall under microscopic examination.Conclusions The first newly report of the existence of a special valvula at the diaphragmatic level of IVC reveals the possibility of high correlation with the occurance of IVC membranous obstruction type in BCS.