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Ann Thorac Surg 1992;54:159-160
© 1992 The Society of Thoracic Surgeons

Articles

Central cyanosis due to prominence of the eustachian and thebesian valves

Hassan Raffa, FRCS(G)*, Khalid Al-Ibrahim, FRCS(C), Mohamed Taher Kayali, FRCS(G), Abdool Aniff Sorefan, FRCS(Eng), Majd Rustom, MD, CES

King Fahd Heart Center, Jeddah, Saudi Arabia

Accepted for publication October 24, 1991.

* Address reprint requests to Dr Raffa, King Fahd Heart Center, PO Box 8488, Jeddah 21196, Saudi Arabia.

A 9-year-old female child with serious central cyanosis was found to have right to left shunt across a large secundum atrial septal defect despite normal right-sided pressures. Preoperative cross-sectional echocardiography suggested the presence of large sinus venosus eustachian and thebesian valves as the mechanism responsible for diversion of the inferior caval and coronary sinus venous return to the left atrium across the interatrial secundum defect. Surgical excision of the unduly prominent sinus venosus valve and patch closure of the atrial septal defect resulted in complete disappearance of the cyanosis and physiological and clinical cure.




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