Kosin Med J.  2020 Dec;35(2):151-155. 10.7180/kmj.2020.35.2.151.

Use of Three-dimensional Transesophageal Echocardiography for the Chiari Network

• Hong JM
• Cho AR
• Baik SH
• Moon DH

• KMID: 2510276
• DOI: http://doi.org/10.7180/kmj.2020.35.2.151

Abstract

The Chiari network is an embryonic remnant of the sinus venosus valve, which is characterized by a fenestrated, netlike structure in the right atrium and has the potential to be misdiagnosed as another right atrial pathology. Additionally, the Chiari network has been frequently reported to entrap intracardiac devices during surgical procedures. In this case report, we present two patients with a Chiari network confirmed by three-dimensional transesophageal echocardiography, which assisted in preventing device entrapment during intracardiac procedures.

Keyword

Chiari network; Swan-Ganz Catheterization; Three-dimensional echocardiography

Figure

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  Fig. 1 (A) Two-dimensional transesophageal echocardiography (TEE) showing a linear structure in the right atrium (arrow). (B) Three-dimensional TEE clearly showing a net-like structure connected to the edge of the IVC and interatrial septum. IAS: interatrial septum; IVC: inferior vena cava; LA: left atrium; RA: right atrium; TV: tricuspid valve.

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  Fig. 2 (A) Two-dimensional transesophageal echocardiography (TEE) imaging does not clearly show the location of the Chiari network (arrow) in relation to the pulmonary artery catheter (PAC, *) (B) Three-dimensional TEE imaging shows that the PAC(*) successfully passed through the tricuspid valve without being entrapped in the Chiari network (arrow). IAS: interatrial septum; IVC: inferior vena cava; LA: left atrium; RA: right atrium; TV: tricuspid valve.

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