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CASE REPORT
Year : 2014  |  Volume : 2  |  Issue : 3  |  Page : 3

A giant eustachian valve protruding into the right ventricle: A case report


1 Intensive Care Unit, University Clinic of Anesthesiology, Reanimation and Intensive Care, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia
2 Department of Cardiology, “8th of September” City Hospital, Skopje, Macedonia
3 Intensive Care Unit, “8th of September” City Hospital, Skopje, Macedonia

Correspondence Address:
Darko Angjushev
Intensive Care Unit, University Clinic of Anesthesiology, Reanimation and Intensive Care, Saints Cyril and Methodius University of Skopje, Skopje
Macedonia
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Source of Support: None, Conflict of Interest: None


DOI: 10.5812/acvi.18786

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Introduction: The Eustachian valve (EV) remnant, when present in adults, is usually rudimentary. However, in echocardiographic examinations, it may appear as a mobile long structure in the right atrium, and it rarely protrudes into the right ventricle. When it is quite large, the EV remnant could be misdiagnosed as a right atrial tumor, thrombus, or vegetation. Case Presentation: An 83-year-old patient was referred to the surgical ward for the excision of a gastric adenocarcinoma. In the course of preoperative assessment, transthoracic echocardiography showed a right atrial mobile filamentous mass that was protruding into the right ventricle. Differential diagnosis included a tumor or thrombus. After a precise evaluation through multiple views, the mass was demonstrated to be a giant EV, 7.3 cm in length. Conclusions: The giant EV remnant can persist in adults and is often diagnosed incidentally via echocardiography. Transthoracic echocardiography is a reliable noninvasive method for the diagnosis of the EV remnant and could help avoid its misdiagnosis as a tumor or thrombus. Nevertheless, sometimes transesophageal echocardiography is necessary to confirm the diagnosis or to demonstrate the existence of an additive clot on it.


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