| Valve of inferior vena cava | |
|---|---|
 Interior of right side of heart. (Valve of inf. vena cava labeled at lower left.) | |
| Details | |
| Identifiers | |
| Latin | valvula venae cavae inferioris |
| TA98 | A12.1.01.015 |
| TA2 | 4032 |
| FMA | 9240 |
| Anatomical terminology | |
The valve of the inferior vena cava (Eustachian valve) is a venous valve that lies at the junction of the inferior vena cava and right atrium.
In prenatal development, the eustachian valve helps direct the flow of oxygen-rich blood through the right atrium into the left atrium and away from the right ventricle. Before birth, the fetal circulation directs oxygen-rich blood returning from the placenta to mix with blood from the hepatic veins in the inferior vena cava. Streaming this blood across the atrial septum via the foramen ovale increases the oxygen content of blood in the left atrium. This in turn increases the oxygen concentration of blood in the left ventricle, the aorta, the coronary circulation and the circulation of the developing brain.
Following birth and separation from the placenta, the oxygen content in the inferior vena cava falls. With the onset of breathing, the left atrium receives oxygen-rich blood from the lungs via the pulmonary veins. As blood flow to the lungs increases, the amount of blood flow entering the left atrium increases. When the pressure in the left atrium exceeds the pressure in the right atrium, the foramen ovale begins to close and limits the blood flow between the left and right atrium. While the eustachian valve persists in adult life, it essentially does not have a specific function after the gestational period.
There is a large variability in size, shape, thickness, and texture of the persistent eustachian valve, and in the extent to which it encroaches on neighboring structures such as the atrial septum. At one end of the spectrum, the embryonic eustachian valve disappears completely or is represented only by a thin ridge. Most commonly, it is a crescentic fold of endocardium arising from the anterior rim of the IVC orifice. The lateral horn of the crescent tends to meet the lower end of the crista terminalis, while the medial horn joins the thebesian valve, a semicircular valvular fold at the orifice of the coronary sinus. At the other extreme, it persists as a mobile, elongated structure projecting several centimeters into the right atrial cavity. In this case, it may demonstrate an undulating motion in real time echocardiography; and when it is quite large, it may be confused with right atrial tumors, thrombi, or vegetations. [1] Occasionally, the eustachian valve crosses the floor of the right atrium from the orifice of the IVC and inserts into the lower portion of the interatrial septum adjacent to the atrioventricular valves. [2] However, higher insertion of a giant eustachian valve, which mimics the echocardiographic appearance of divided right atrium, is very rare. This type of abnormality may be confused with cor triatriatum dexter. [3] Very rarely, such a configuration of a large eustachian valve may mimic a right atrial cystic tumor. [4]
The superior vena cava (SVC) does not have any homologous valve or valvule.
The eustachian valve is frequently seen with transthoracic echocardiography from the parasternal long axis, the apical four-chamber and the sub-costal four-chamber views. The eustachian valve is better seen with transesophageal echocardiography in the bi-caval view and right sided horizontal and longitudinal views.
Association between the eustachian valve and patent foramen ovale has been studied in patients with cryptogenic stroke (stroke of unknown cause).
The eustachian valve, also called valvula venae cavae inferioris, was described for the first time by the Italian anatomist Bartolomeo Eustachi (born between 1500 and 1513, died 1574).
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest, called the mediastinum.
The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra.
Mitral stenosis is a valvular heart disease characterized by the narrowing of the opening of the mitral valve of the heart. It is almost always caused by rheumatic valvular heart disease. Normally, the mitral valve is about 5 cm2 during diastole. Any decrease in area below 2 cm2 causes mitral stenosis. Early diagnosis of mitral stenosis in pregnancy is very important as the heart cannot tolerate increased cardiac output demand as in the case of exercise and pregnancy. Atrial fibrillation is a common complication of resulting left atrial enlargement, which can lead to systemic thromboembolic complications such as stroke.
Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atria of the heart. Some flow is a normal condition both pre-birth and immediately post-birth via the foramen ovale; however, when this does not naturally close after birth it is referred to as a patent (open) foramen ovale (PFO). It is common in patients with a congenital atrial septal aneurysm (ASA).
Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.
The atrium is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.
A transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound. In this case, the probe is placed on the chest or abdomen of the subject to get various views of the heart. It is used as a non-invasive assessment of the overall health of the heart, including a patient's heart valves and degree of heart muscle contraction. The images are displayed on a monitor for real-time viewing and then recorded.
The fossa ovalis is a depression in the right atrium of the heart, at the level of the interatrial septum, the wall between right and left atrium. The fossa ovalis is the remnant of a thin fibrous sheet that covered the foramen ovale during fetal development.
In the fetal heart, the foramen ovale, also foramen Botalli or the ostium secundum of Born, allows blood to enter the left atrium from the right atrium. It is one of two fetal cardiac shunts, the other being the ductus arteriosus. Another similar adaptation in the fetus is the ductus venosus. In most individuals, the foramen ovale closes at birth. It later forms the fossa ovalis.
The interatrial septum is the wall of tissue that separates the right and left atria of the heart.
In humans, the circulatory system is different before and after birth. The fetal circulation is composed of the placenta, umbilical blood vessels encapsulated by the umbilical cord, heart and systemic blood vessels. A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and nutrients from the placenta to the fetal tissue. At birth, the start of breathing and the severance of the umbilical cord prompt various changes that quickly transform fetal circulation into postnatal circulation.
The coronary sinus is the largest vein of the heart. It drains over half of the deoxygenated blood from the heart muscle into the right atrium. It begins on the backside of the heart, in between the left atrium, and left ventricle; it begins at the junction of the great cardiac vein, and oblique vein of the left atrium. It receives multiple tributaries. It passes across the backside of the heart along a groove between left atrium and left ventricle, then drains into the right atrium at the orifice of the coronary sinus.
The foramen secundum, or ostium secundum is a foramen in the septum primum, a precursor to the interatrial septum of the human heart.
A cardiac shunt is a pattern of blood flow in the heart that deviates from the normal circuit of the circulatory system. It may be described as right-left, left-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic. The direction may be controlled by left and/or right heart pressure, a biological or artificial heart valve or both. The presence of a shunt may also affect left and/or right heart pressure either beneficially or detrimentally.
Lutembacher's syndrome is a very rare form of congenital heart disease that affects one of the chambers of the heart as well as a valve. It is commonly known as both congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Congenital atrial septal defect refers to a hole being in the septum or wall that separates the two atria; this condition is usually seen in fetuses and infants. Mitral stenosis refers to mitral valve leaflets sticking to each other making the opening for blood to pass from the atrium to the ventricles very small. With the valve being so small, blood has difficulty passing from the left atrium into the left ventricle. Septal defects that may occur with Lutembacher's syndrome include: Ostium primum atrial septal defect or ostium secundum which is more prevalent.
A double inlet left ventricle (DILV) or "single ventricle", is a congenital heart defect appearing in 5 in 100,000 newborns, where both the left atrium and the right atrium feed into the left ventricle. The right ventricle is hypoplastic or does not exist.
Crista dividens is a structure in the developing heart of the human embryo that divides the right atrium in a way such that it creates a pan systolic murmur in the same way as the foramen ovale. Recognition of the absence of this murmur can indicate a potentially terminal cardiac defect in the newborn.
Heart development, also known as cardiogenesis, refers to the prenatal development of the heart. This begins with the formation of two endocardial tubes which merge to form the tubular heart, also called the primitive heart tube. The heart is the first functional organ in vertebrate embryos.
The heart is a muscular organ situated in the mediastinum. It consists of four chambers, four valves, two main arteries, and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left side receives saturated blood from the lungs.
Raghib syndrome is rare a congenital heart defect where the left superior vena cava (LSVC) is draining into the left atrium in addition to an absent coronary sinus and an atrial septal defect. This can be considered a dangerous heart condition because it puts the individual at a high risk of stroke. Other defects that are often associated with Raghib syndrome can include ventricular septal defects, enlargement of the tricuspid annulus, and pulmonary stenosis. While this is considered an extremely rare developmental complex, cases regarding a persistent left superior vena cava (PLSVC) are relatively common among congenital heart defects. It is also important to note that the PLSVC often drains into the right atrium, and only drains into the left atrium in approximately 10 to 20% of individuals with the defect.
This article incorporates text in the public domain from page 540 of the 20th edition of Gray's Anatomy (1918)
