Obstructing Eustachian valve in a newborn presenting with profound hypoxemia and atrial arrhythmias | Lurie Children's

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Obstructing Eustachian valve in a newborn presenting with profound hypoxemia and atrial arrhythmias

Wolfe, B.; Stephens, E.; Tannous, P; Kalinowski, V.; Lay, A.; Forbess, J.; Ramlogan, S.

JTCVS Tech. 2020 Apr 11; (3):265-266

Abstract

In fetal circulation, the Eustachian valve (EV) directs inferior vena cava blood (oxygenated blood from the placenta) across the patent foramen ovale (PFO). As the pulmonary vascular resistance drops after birth, this blood is no longer shunted to the left atrium and proceeds through the right heart to the lungs. However, in very rare instances, if the EV is large and nonfenestrated, it can cause postnatal obstruction to normal antegrade blood flow across the tricuspid valve. This leads to a large, persistent right-to-left shunt with subsequent systemic hypoxemia.

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