Key result
Chiari network prevents fatal pulmonary embolism by entrapping large thrombus as an intrinsic filter.
Why the study?
The role of the Chiari network in thrombo-embolic disease is controversial, with uncertainty whether it acts as a risk factor or protective filter against pulmonary embolism.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
May indicate protective filter function of Chiari network; hypothesis-generating and should not yet change practice.
The Chiari network, a net-like structure within the right atrium, has been described as an embryonic remnant of no clinical significance. Its role in facilitating paradoxical arterial embolic events and as a potential site for thrombus formation however, has been reported in the literature. This case illustrates the protective filter-effect of the Chiari network in a 79-year-old Caucasian man with an unknown diagnosis of polycythaemia rubra vera who presented with clinical signs and symptoms of deep vein thrombosis. Transoesophageal echocardiogram confirmed entrapment of a thrombus within the Chiari network, which was not visualised following treatment on repeat scanning 1 month later. Here the authors describe how the Chiari network may have prevented the occurrence of a fatal massive pulmonary embolism in a patient with a high pro-thrombotic tendency, and review the current literature regarding the action of this anatomic variant as risk factor or protector.
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Obaji et al. (2012) conducted a case report in Polycythaemia rubra vera with deep vein thrombosis (n=1). Chiari network was evaluated on Thrombus entrapment preventing massive pulmonary embolism. The Chiari network served as a protective intrinsic filter by entrapping a large thrombus, preventing a fatal massive pulmonary embolism in a patient with polycythaemia rubra vera.
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