INTERESTING CASES AND FINDINGS

Incidental finding in a 72year old female undergoing a mitral valve replacement. The clips start with an RV inflow/outflow view, here note the hyperechoic mobile linear density in the 10-11o'clock position "up" in the right atrium. The following clips zoom in on that structure. The membrane also appears to be fenestrated based on the bubble study. Lastly, the patient was found to have an atrial septal defect. Is this a giant Eustachian valve or did we find the unicorn of right heart congenital abnormalities? Much debate was had at our program.

For discussion, take a look at this article from JASE.

Cor Triatriatum Dexter and Sinister Appearance Caused by Giant Eustachian Valve and Prominent Interatrial Septal Aneurysm
Ozeke, Ozcan et al.Journal of the American Society of Echocardiography, Volume 21, Issue 1, 91.e1 - 91.e2

Beautiful example of a flail posterior mitral valve leaflet resulting in severe eccentric mitral regurgitation. Last several clips include a 3D reconstruction with photorealistic rendering in an oblique angle looking medial to lateral on the mitral valve. This particular rendering always reminds me of some globular sea creature! View the video below to see the outcome of our intervention.