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Incidental discovery of an unusual right atrial membrane in an adult patient


Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence Address:
Priya A Kumar
Department of Anesthesiology, N2201 University of North Carolina Hospitals, Campus Box 7010, Chapel Hill, NC 27599-7010
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.101870

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Year : 2012  |  Volume : 15  |  Issue : 4  |  Page : 309-311

 

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We describe presence of an unusual right atrial membrane in a 30-year old female with end stage renal disease, hypertension and peripheral vascular disease. The patient was scheduled for midline sternotomy and pericardiotomy and removal of a migrated vascular stent in the right pulmonary artery. An intraoperative transesophageal echocardiogram (TEE) revealed an unusual membranous structure with fenestrations that stretched across the right atrium with attachments superiorly at the free wall and inferiorly at the inter-atrial septum. There was no evidence of flow obstruction across the tricuspid valve. Some of the considerations for the likely diagnosis of this structure were a prominent Eustachian valve, persistent Chiari network, aneurysmal inter-atrial septum, an inter-atrial septal cyst or Cor triatriatum dexter (CTD).






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Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence Address:
Priya A Kumar
Department of Anesthesiology, N2201 University of North Carolina Hospitals, Campus Box 7010, Chapel Hill, NC 27599-7010
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.101870

Rights and Permissions

We describe presence of an unusual right atrial membrane in a 30-year old female with end stage renal disease, hypertension and peripheral vascular disease. The patient was scheduled for midline sternotomy and pericardiotomy and removal of a migrated vascular stent in the right pulmonary artery. An intraoperative transesophageal echocardiogram (TEE) revealed an unusual membranous structure with fenestrations that stretched across the right atrium with attachments superiorly at the free wall and inferiorly at the inter-atrial septum. There was no evidence of flow obstruction across the tricuspid valve. Some of the considerations for the likely diagnosis of this structure were a prominent Eustachian valve, persistent Chiari network, aneurysmal inter-atrial septum, an inter-atrial septal cyst or Cor triatriatum dexter (CTD).






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