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Chiari network endocarditis: not just an innocent bystander

Negareh Mousavi1, Kapil Bhagirath, Vignendra Ariyarajah

  • 1Section of Cardiology, Department of Cardiac Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Echocardiography (Mount Kisco, N.Y.)
|May 16, 2008
PubMed

Insights

A Chiari network, a rare right atrial remnant, complicated infective endocarditis in a 67-year-old male. Surgical intervention was required due to persistent vegetations on the tricuspid valve and Chiari network.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Chiari's network is a congenital remnant of the sinus venosum valve, found in about 2% of the population.
  • Infective endocarditis involves infection of the heart's inner lining or valves.

Observation:

  • A 67-year-old male presented with acute infective endocarditis of the tricuspid valve caused by coagulase-negative Staphylococci.
  • Despite two weeks of antimicrobial therapy, the patient remained febrile with septic pulmonary emboli.

Findings:

  • Transthoracic echocardiography revealed persistent vegetations on the tricuspid valve.
  • These vegetations extended onto the Chiari network, a rare anatomical variant in the right atrium.

Implications:

  • The presence of Chiari's network can complicate infective endocarditis management.
  • Surgical intervention may be necessary when vegetations involve anatomical variants like Chiari's network.

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