Key result
A prominent eustachian valve represents an increased risk factor for left circulation paradoxical thromboembolism in patients with right-to-left shunting via a patent foramen ovale.
Why the study?
A large eustachian valve and other right atrial anatomical variants may represent an increased risk factor for paradoxical thromboembolism in patients evaluated for transcatheter PFO closure.
A prominent Eustachian valve is an important anatomical risk factor that fosters paradoxical thromboembolism in patients with a patent foramen ovale and requires careful echocardiographic assessment prior to percutaneous closure.
Catheter-based closure of patent foramen ovale (PFO) is more effective than medical therapy in the prevention of recurrent stroke[1]. It is likely that a proportion of patients evaluated for potential transcatheter PFO closure has actually different anatomical variants particularly common in the right atrium such as eustachian valve, Chiari network, Thebesian valve and Crista Terminalis. Notably, the eustachian valve may represent an increased risk factor for left circulation thromboembolism beyond that associated with PFO size and shunting. Such patients may benefit the most from percutaneous closure procedure.
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Eustaquio Onorato (2021) conducted a review in Patent foramen ovale and paradoxical thromboembolism. Prominent eustachian valve vs. Absence of prominent eustachian valve was evaluated. A prominent eustachian valve represents an increased risk factor for left circulation paradoxical thromboembolism in patients with right-to-left shunting via a patent foramen ovale.
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