In prenatal development, the eustachian valve helps direct the flow of oxygen-rich blood through the right atrium into the left atrium and away from the right ventricle. Before birth, the fetal circulation directs oxygen-rich blood returning from the placenta to mix with blood from the hepatic veins in the inferior vena cava. Streaming this blood across the atrial septum via the foramen ovale increases the oxygen content of blood in the left atrium. This in turn increases the oxygen concentration of blood in the left ventricle, the aorta, the coronary circulation and the circulation of the developing brain.
Following birth and separation from the placenta, the oxygen content in the inferior vena cava falls. With the onset of breathing, the left atrium receives oxygen-rich blood from the lungs via the pulmonary veins. As blood flow to the lungs increases, the amount of blood flow entering the left atrium increases. When the pressure in the left atrium exceeds the pressure in the right atrium, the foramen ovale begins to close and limits the blood flow between the left and right atrium. While the eustachian valve persists in adult life, it essentially does not have a specific function after the gestational period.
Variationedit
There is a large variability in size, shape, thickness, and texture of the persistent eustachian valve, and in the extent to which it encroaches on neighboring structures such as the atrial septum. At one end of the spectrum, the embryonic eustachian valve disappears completely or is represented only by a thin ridge. Most commonly, it is a crescentic fold of endocardium arising from the anterior rim of the IVC orifice. The lateral horn of the crescent tends to meet the lower end of the crista terminalis, while the medial horn joins the thebesian valve, a semicircular valvular fold at the orifice of the coronary sinus. At the other extreme, it persists as a mobile, elongated structure projecting several centimeters into the right atrial cavity. In this case, it may demonstrate an undulating motion in real time echocardiography; and when it is quite large, it may be confused with right atrial tumors, thrombi, or vegetations.[1] Occasionally, the eustachian valve crosses the floor of the right atrium from the orifice of the IVC and inserts into the lower portion of the interatrial septum adjacent to the atrioventricular valves.[2] However, higher insertion of a giant eustachian valve, which mimics the echocardiographic appearance of divided right atrium, is very rare. This type of abnormality may be confused with cor triatriatum dexter.[3] Very rarely, such a configuration of a large eustachian valve may mimic a right atrial cystic tumor.[4]
The superior vena cava (SVC) does not have any homologous valve or valvule.
Clinical significanceedit
The eustachian valve is frequently seen with transthoracic echocardiography from the parasternal long axis, the apical four-chamber and the sub-costal four-chamber views. The eustachian valve is better seen with transesophageal echocardiography in the bi-caval view and right sided horizontal and longitudinal views.
Association between the eustachian valve and patent foramen ovale has been studied in patients with cryptogenic stroke (stroke of unknown cause).
Historyedit
The eustachian valve, also called valvula venae cavae inferioris, was described for the first time by the Italian anatomist Bartolomeo Eustachi (born between 1500 and 1513, died 1574).
Referencesedit
This article incorporates text in the public domain from page 540 of the 20th edition ofGray's Anatomy(1918)
^D'Cruz IA. Echocardiographic anatomy: understanding normal and abnormal echocardiograms. 1st ed. Stamford (CT): Appleton & Lange; 1996. p. 114–5
^Otto CM, editor. The practice of clinical echocardiography. 1st ed. Philadelphia: WB Saunders; 1997. p. 668.
^Otto CM, editor. The practice of clinical echocardiography. 1st ed. Philadelphia: WB Saunders; 1997. p. 668.
^Malaterre HR, Kallee K, Perier Y. Eustachian valve mimicking a right atrial cystic tumor. Int J Card Imaging 2000;16(4):305–7.
External linksedit
Atlas image: ht_rt_atrium at the University of Michigan Health System - "Right atrium, internal structure, anterior view"
valve, inferior, vena, cava, valve, inferior, vena, cava, eustachian, valve, venous, valve, that, lies, junction, inferior, vena, cava, right, atrium, interior, right, side, heart, valve, vena, cava, labeled, lower, left, detailsidentifierslatinvalvula, venae,. The valve of the inferior vena cava eustachian valve is a venous valve that lies at the junction of the inferior vena cava and right atrium Valve of inferior vena cavaInterior of right side of heart Valve of inf vena cava labeled at lower left DetailsIdentifiersLatinvalvula venae cavae inferiorisTA98A12 1 01 015TA24032FMA9240Anatomical terminology edit on Wikidata View of the inferior vena cava ostium IVCO with Eustachian valve EusV present in a human heart Contents 1 Development 2 Variation 3 Clinical significance 4 History 5 References 6 External linksDevelopment editIn prenatal development the eustachian valve helps direct the flow of oxygen rich blood through the right atrium into the left atrium and away from the right ventricle Before birth the fetal circulation directs oxygen rich blood returning from the placenta to mix with blood from the hepatic veins in the inferior vena cava Streaming this blood across the atrial septum via the foramen ovale increases the oxygen content of blood in the left atrium This in turn increases the oxygen concentration of blood in the left ventricle the aorta the coronary circulation and the circulation of the developing brain Following birth and separation from the placenta the oxygen content in the inferior vena cava falls With the onset of breathing the left atrium receives oxygen rich blood from the lungs via the pulmonary veins As blood flow to the lungs increases the amount of blood flow entering the left atrium increases When the pressure in the left atrium exceeds the pressure in the right atrium the foramen ovale begins to close and limits the blood flow between the left and right atrium While the eustachian valve persists in adult life it essentially does not have a specific function after the gestational period Variation editThere is a large variability in size shape thickness and texture of the persistent eustachian valve and in the extent to which it encroaches on neighboring structures such as the atrial septum At one end of the spectrum the embryonic eustachian valve disappears completely or is represented only by a thin ridge Most commonly it is a crescentic fold of endocardium arising from the anterior rim of the IVC orifice The lateral horn of the crescent tends to meet the lower end of the crista terminalis while the medial horn joins the thebesian valve a semicircular valvular fold at the orifice of the coronary sinus At the other extreme it persists as a mobile elongated structure projecting several centimeters into the right atrial cavity In this case it may demonstrate an undulating motion in real time echocardiography and when it is quite large it may be confused with right atrial tumors thrombi or vegetations 1 Occasionally the eustachian valve crosses the floor of the right atrium from the orifice of the IVC and inserts into the lower portion of the interatrial septum adjacent to the atrioventricular valves 2 However higher insertion of a giant eustachian valve which mimics the echocardiographic appearance of divided right atrium is very rare This type of abnormality may be confused with cor triatriatum dexter 3 Very rarely such a configuration of a large eustachian valve may mimic a right atrial cystic tumor 4 The superior vena cava SVC does not have any homologous valve or valvule Clinical significance editThe eustachian valve is frequently seen with transthoracic echocardiography from the parasternal long axis the apical four chamber and the sub costal four chamber views The eustachian valve is better seen with transesophageal echocardiography in the bi caval view and right sided horizontal and longitudinal views Association between the eustachian valve and patent foramen ovale has been studied in patients with cryptogenic stroke stroke of unknown cause History editThe eustachian valve also called valvula venae cavae inferioris was described for the first time by the Italian anatomist Bartolomeo Eustachi born between 1500 and 1513 died 1574 References edit nbsp This article incorporates text in the public domain from page 540 of the 20th edition of Gray s Anatomy 1918 D Cruz IA Echocardiographic anatomy understanding normal and abnormal echocardiograms 1st ed Stamford CT Appleton amp Lange 1996 p 114 5 Otto CM editor The practice of clinical echocardiography 1st ed Philadelphia WB Saunders 1997 p 668 Otto CM editor The practice of clinical echocardiography 1st ed Philadelphia WB Saunders 1997 p 668 Malaterre HR Kallee K Perier Y Eustachian valve mimicking a right atrial cystic tumor Int J Card Imaging 2000 16 4 305 7 External links editAtlas image ht rt atrium at the University of Michigan Health System Right atrium internal structure anterior view Portal nbsp Anatomy Retrieved from https en wikipedia org w index php title Valve of inferior vena cava amp oldid 1125425134, wikipedia, wiki, book, books, library,
