Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 31  |  Issue : 1  |  Page : 57-58

Band-like remnant of the embryonic right valve of the sinus venosus as an incidental finding in an elderly woman


Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Date of Submission28-Sep-2020
Date of Acceptance02-Jan-2021
Date of Web Publication20-May-2021

Correspondence Address:
Ali Hosseinsabet
Karegar Shomali Street, Tehran Heart Center, Tehran University of Medical Sciences, Tehran
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcecho.jcecho_107_20

Rights and Permissions

How to cite this article:
Hadadi M, Hosseinsabet A. Band-like remnant of the embryonic right valve of the sinus venosus as an incidental finding in an elderly woman. J Cardiovasc Echography 2021;31:57-8

How to cite this URL:
Hadadi M, Hosseinsabet A. Band-like remnant of the embryonic right valve of the sinus venosus as an incidental finding in an elderly woman. J Cardiovasc Echography [serial online] 2021 [cited 2021 Jun 25];31:57-8. Available from: https://www.jcecho.org/text.asp?2021/31/1/57/316511



A short-statured 79-year-old woman with dyspnea on exertion (functional Class II according to the New York Heart Association calcification) referred to our echocardiography laboratory for further evaluation. She had a history of diabetes mellitus and hypertension, and her heart rhythm was atrial fibrillation. All these conditions were treated medically. A two-dimensional transthoracic echocardiographic examination demonstrated a ridge-like band originating from the crista terminalis and running parallel to the interatrial septum. The band crossed through the right atrial cavity and attached to the lateral wall of the right atrium. [Figure 1] The band was immobile, without fenestration. Color Doppler study showed that the band did not produce any obstruction. These findings were in favor of the remnant of the embryonic right valve of the sinus venosus, such that this embryonic valve in its complete shape could result in cor triatriatum dexter. A three-dimensional transthoracic echocardiographic examination confirmed these findings. [Video 1] The other echocardiographic findings were severe left ventricular enlargement with mild systolic dysfunction (ejection fraction ≈50%), mild right ventricular enlargement with mild systolic dysfunction, severe left and right atrial enlargement, moderate-to-severe aortic regurgitation, mild-to-moderate mitral regurgitation, and moderate-to-severe tricuspid regurgitation (tricuspid regurgitation gradient = 25 mm Hg and estimated systolic pulmonary artery pressure = 35 mm Hg). The interatrial septum was intact in color Doppler study.
Figure 1: (a) Modified 5-chamber view in two-dimensional echocardiography shows the presence of a band in the right atrium originating from the crista terminalis and dividing the right atrium. (b) Short-axis view at the level of aortic valve reveals the a ridge (c) In the subcostal bicaval view, the band runs parallel to the interatrial septum and the orifice of the inferior and superior venae cavae and opens to the posterior chamber. (d) In live three-dimensional transthoracic echocardiography, the presence of this band is illustrated. AO = Aorta, LA = Left atrium, LV = Left ventricle, RA = Right atrium

Click here to view



Cor triatriatum dexter is a very rare congenital anomaly caused by a dividing membrane in the right atrium. The membrane is a remnant of the embryonic right valve of the sinus venosus.[1] The presenting symptoms are associated with other structural defects and the presence or absence of obstruction.[2] In addition, supraventricular arrhythmias such as atrial fibrillation in this condition have been reported.[3] The most common condition in the differential diagnosis of cor triatriatum dexter is an elongated  Eustachian valve More Details. This right atrial structure originates from the anterior part of the orifice of the inferior vena cava and courses toward the interatrial septum; nonetheless, the membrane in cor triatriatum dexter originates from the crista terminalis.[1],[2],[4] In our case, there was a band-like (not membrane) remnant of the embryonic right valve of the sinus venosus, which may have been due to the incomplete resolution of the aforementioned valve, so that only 1 band of this membrane had remained. Although this anomaly is very rare in the daily practice, the presence of this anomaly should always be kept in mind.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Moral S, Ballesteros E, Huguet M, Panaro A, Palet J, Evangelista A. Differential diagnosis and clinical implications of remnants of the right valve of the sinus venosus. J Am Soc Echocardiogr 2016;29:183-94.  Back to cited text no. 1
    
2.
Bindra BS, Patel Z, Patel N, Choudhary KV, Patel V. Cor triatriatum dexter as an incidental finding: Role of two-dimensional transthoracic echocardiography. Cureus 2019;11:E5683.  Back to cited text no. 2
    
3.
Tzeis S, Asvestas D, Sakadakis E, Trika C, Vardas P. Atrial fibrillation cryoablation in cor triatriatum dexter. Europace 2020;22:1.  Back to cited text no. 3
    
4.
Morita Y, Yoshitomi H, Ishikura M, Endo A, Tanabe K. Cor triatriatum dexter associated with atrial septal defect and mitral valve regurgitation. J Echocardiogr 2019. [doi: 10.1007/s12574-019-00444-x].  Back to cited text no. 4
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References
Article Figures

 Article Access Statistics
    Viewed116    
    Printed0    
    Emailed0    
    PDF Downloaded8    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]