Korean J Radiol.  2012 Aug;13(4):500-504. 10.3348/kjr.2012.13.4.500.

Intracardiac Eustachian Valve Cyst in an Adult Detected with Other Cardiac Anomalies: Usefulness of Multidetector CT in Diagnosis

• Cho HJ
• Jung JI
• Kim HW
• Lee KY

• KMID: 1383864
• DOI: http://doi.org/10.3348/kjr.2012.13.4.500

Abstract

We present an unusual case of an intracardiac Eustachian valve cyst observed concurrently with atresia of the coronary sinus ostium, a persistent left superior vena cava (LSVC) and a bicuspid aortic valve. There have been several echocardiographic reports of Eustachian valve cysts; however, there is no report of multidetector computed tomography (MDCT) findings related to a Eustachian valve cyst. Recently, we observed a Eustachian valve cyst diagnosed on MDCT showing a hypodense cyst at the characteristic location of the Eustachian valve (the junction of the right atrium and inferior vena cava). MDCT also demonstrated additional cardiovascular anomalies including atresia of the coronary sinus ostium and a persistent LSVC and bicuspid aortic valve.

Keyword

Heart valve; Congenital anomaly; Computed tomography; spiral; Coronary sinus; Eustachian valve cyst

MeSH Terms

Aged
Aortic Valve/abnormalities/radiography
Cysts/*radiography
Echocardiography, Transesophageal
Heart Atria/abnormalities/radiography
Heart Defects, Congenital/*radiography/surgery
Humans
Male
*Tomography, X-Ray Computed
Vena Cava, Inferior/abnormalities/radiography
Vena Cava, Superior/abnormalities/radiography

Figure

• 

  Fig. 1 Intracardiac Eustachian valve cyst in 71-year-old man with other cardiac anomaly including atresia of coronary sinus ostium, persistent left superior vena cava and bicuspid aortic valve. A. Axial contrast-enhanced chest CT shows 1.7-cm lobulating contoured hypodense mass at junction of right atrium and inferior vena cava (arrow). Note dilated coronary sinus (arrowhead). B. Cardiac CT with multiplanar reformatted image shows bicuspid aortic valve with raphe (arrow) and dense calcification, suggesting aortic stenosis. C. Sagittal multiplanar reformatted image of cardiac CT shows dilated coronary sinus connected to persistent left superior vena cava (arrows), which drains into left innominate vein (not shown). D. Volume-rendered CT image shows dilated coronary sinus (CS) and cardiac veins (arrows). E. Transesophageal echocardiogram shows 2 × 1-cm oval echogenic mass attached to right atrium wall that contains internal anechoic cystic lesion (arrow). F. Pathology shows (H & E stain × 100) pseudocyst induced through fibromyxoid degeneration and flattening of wall with blood.

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