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Angiology
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*Arteriovenous Malformations
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Persistent Eustachian Valve Causing Severe Cyanosis in Atrial Septal Defect with Normal Right Heart Pressures

Tali Bashour

Department of Medicine, Division of Cardiology, Damascus University School of Medicine, Damascus, Syria, and the Department of Medicine, Division of Cardiology, The George Washington University School of Medicine and Medical Center, Washington, D.C., U.S.A.

Sami Kabbani

Department of Medicine, Division of Cardiology, Damascus University School of Medicine, Damascus, Syria, and the Department of Medicine, Division of Cardiology, The George Washington University School of Medicine and Medical Center, Washington, D.C., U.S.A.

Michel Saalouke

Department of Medicine, Division of Cardiology, Damascus University School of Medicine, Damascus, Syria, and the Department of Medicine, Division of Cardiology, The George Washington University School of Medicine and Medical Center, Washington, D.C., U.S.A.

Tsung O. Cheng

Department of Medicine, Division of Cardiology, Damascus University School of Medicine, Damascus, Syria, and the Department of Medicine, Division of Cardiology, The George Washington University School of Medicine and Medical Center, Washington, D.C., U.S.A.

A 22-year-old female with cyanotic congenital heart disease was found to have veno-arterial shunting via a large secundum atrial septal defect despite normal pulmonary arterial and right ventricular pressures. Persistence of the Eustachian valve of the inferior vena cava was suspected preoperatively and confirmed at operation. This valve caused a large right-to-left shunt by favoring the flow of inferior vena caval blood into the left atrium via the defect. Surgical excision of the abnormal valve and closure of the atrial septal defect resulted in complete physiological and clinical cure.

Angiology, Vol. 34, No. 2, 79-83 (1983)
DOI: 10.1177/000331978303400201
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