Three-dimensional imaging of redundant Chiari's network prolapsing into right ventricle.
An asymptomatic 1-month-old girl was studied in another institution because of the presence of a cardiac murmur, and referred to our center for further evaluation as a result of tricuspid valve abnormalities detected in the echocardiographic study. Echocardiography revealed a very redundant, thin, freely mobile structure in the right atrium, moving rapidly in (systole) and out (diastole) of the right ventricle through the tricuspid orifice. It arose from near the border of the inferior vena cava and attached to the atrial wall close to the coronary sinus ostium, suggesting an unusually prominent Chiari's network. Three-dimensional imaging allowed definition of the structure in all the planes and dimensions, and the relationship of the structure with right atrium and ventricle. Chiari's network is an embryonic remnant present in 2% to 3% of the population. The identification of a Chiari's network is important because the widely mobile structure within the right atrium can be confused with other entities, such as right heart vegetation, flail tricuspid leaflet, ruptured chordae tendinae, or a thrombus.
Betrián Blasco
Pedro
P
Pediatric Cardiology Department, Valle de Hebrón Hospital, Barcelona, Spain. pedrobetrian@yahoo.es
Sarrat Torres
Rebeca
R
Pijuan Domènech
Maria Antonia
MA
Marimón Blanch
Cristina
C
Pérez Herrera
Verónica
V
Girona Comas
Josep
J
D019560:Echocardiography, Three-Dimensional; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index