Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul;25(3):225-9.
doi: 10.1016/j.jsha.2012.12.002. Epub 2013 Jan 8.

Chiari network: A case report and brief overview

A K M Monwarul Islam  1 , Lima Asrin Sayami, Shahana Zaman
Affiliations

Chiari network: A case report and brief overview

A K M Monwarul Islam et al. J Saudi Heart Assoc. 2013 Jul.

Abstract

The Chiari network is mobile, net-like structures occasionally seen in right atrium near the opening of inferior vena cava and coronary sinus. This is usually of no clinical significance and is often diagnosed incidentally. However, sometimes it may cause diagnostic confusion with right atrial pathologies, and may favour thromboembolism by causing flow obstruction. It may be associated with infective endocarditis, arrhythmias, and migraine. Sometimes, it acts as a physical barrier during invasive procedures. The Chiari network has also been described to protect from pulmonary embolism by acting as an inferior vena cava filter due to its sieve-like effect at the cavo-atrial junction. Here, the Chiari network has been described in a case of Ebstein anomaly of tricuspid valve which produced diagnostic confusion during echocardiography. A brief overview has also been presented.

Keywords: Coronary sinus; Ebstein anomaly; Inferior vena cava.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Electrocardiogram of the patient at presentation showing regular wide-complex tachycardia (left panel), which was reverted to sinus rhythm showing pre-excitation (right panel).
Figure 2
Figure 2
Echocardiography showing the Chiari network (CN) with apically displaced tricuspid valve (TV) in apical 4-chamber view (panel A), in right ventricular inflow view (panel B), and laminar flow across the atrial septal defect (panel C).
Figure 3
Figure 3
Schematic representation of development of the Chiari network. (A) Posterior view of developing heart with the sinus venosus. (B) Interior of adult right atrium showing opening of inferior vena cava and coronary sinus. (C) Interior of right atrium showing opening of inferior vena cava, coronary sinus and the Chiari network. Here, LA = left atrium, RA = right atrium, RSH = right horn of sinus venosus, LSH = left horn of sinus venosus, CC = common cardinal vein, VV = vitelline vein, UV = umbilical vein, IVC = inferior vena cava, CS = coronary sinus, CN = Chiari network.
None
See this image and copyright information in PMC

References

    1. Loukas M., Sullivan A., Tubbs R.S., Weinhaus A.J., DerDerian T., Hanna M. Chiari’s network: review of the literature. Surg Radiol Anat. 2010;32(10):895–901. - PubMed
    1. Bhatnagar K.P., Nettleton G.S., Campbell F.R., Wagner C.E., Kuwabara N., Muresian H. Chiari anomalies in the human right atrium. Clin Anat. 2006;19:510–516. - PubMed
    1. Chiari H. Ueber Netzbildungen im rechten Vorhofedes Herzens. Beitr Pathol Anat. 1897;22:1–10.
    1. Gresham G.A. Networks in the right side of the heart. Br Heart J. 1957;19:381–386. - PMC - PubMed
    1. Yater W.M. Variations and anomalies of the venous valves of the right atrium of the human heart. Arch Pathol. 1929;7:418–441.

LinkOut - more resources